PMC4996586_01
TRUS showing a tubular cystic structure inserting to the site of left ED associated with prominent terminal part of vas deferens (left EDO). ED, ejaculatory duct; EDO, ejaculatory duct obstruction; TRUS, transrectal ultrasonography.
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Transrectal ultrasonography (TRUS) (Fig. 1) showed evidence of tubular cystic structure inserting into the site of the ejaculatory duct (ED) on the left side associated with prominent terminal part of the vas deferens.
(A) Coronal section of a contrast-enhanced abdominal computed tomography showing single right kidney, left kidney agenesis, and right-sided seminal vesicular cystic dilatation. (B) Axial section single right kidney with evidence of compensated hypertrophy.
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Then a prominent verumontanum was identified at the prostatic urethra (Fig. 2A). After deroofing, a dilated seminal vesicle appeared from inside (Fig. 2B) with a brownish opaque fluid coming out.
(A) Prominent verumontanum at prostatic urethra on rigid endoscopic examination (underlying EDO). (B) Post-TURED deroofing of verumontanum showing a large cavity with dilated seminal vesicular pockets. TURED, transuretral resection of the ejaculatory duct.
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However, it was only after the TURED there was a chance to send for a retrospective computed tomography (Fig. 3A), at least to confirm the renal agenesis and complete the triad of the syndrome, which revealed single right-sided kidney with compensated hypertrophy and nonobservable left kidney (agenesis).