Congenital seminal vesicle cysts with ipsilateral renal agenesis are rare [1, 2] . Small seminal vesicle cysts (< 5 cm) are usually asymptomatic, whereas larger cysts lead to urinary obstructive symptoms [2] . Uroflowmetry can be used to quantify the clinical symptoms in young adult patients. CASE PRESENTATION In July 2008, a 43-year-old married, infertile man presented to our department with a 3-year history of difficulty in urination and irritating voiding symptoms. He initially paid little

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... tention to these symptoms. However, his genitourinary discomfort had worsened over the preceding 6 months. His International Prostatic Symptom Score was 13. A physical examination showed normal external genitalia, but a digital rectal examination revealed a soft, large cystic mass in the prostatic region. All laboratory data were within normal ranges. Semen analysis revealed predominantly immotile spermatozoa (grade D, 59.5%). Intravenous pyelography could not depict the left kidney or ureter and showed a contrast-filling defect of the left posterolateral surface of the bladder (Figure 1 ). Computed tomography of the abdomen and pelvis confirmed left renal agenesis and the presence of a left seminal vesicle cyst (Figures 2A and 2B) . Magnetic resonance imaging of the pelvis also demonstrated a seminal vesicle cyst, causing indentation of the bladder base (Figure 3 ). Preaspiration uroflowmetry studies revealed a maximal urinary flow rate of 18 mL/s and a mean urinary flow rate of 6 mL/s. The residual urine volume was 99 mL. Seminal vesicle cysts combined with genitourinary anomalies are uncommon. We present a 43-year-old married man who suffered from difficulty in urination and irritating voiding symptoms for 3 years. The symptoms worsened in the last 6 months. Digital rectal examination revealed a palpable large soft mass behind the prostate. Diagnostic imaging showed a left seminal vesicle cyst with an intravesical protrusion. The ipsilateral kidney and ureter were absent. Transrectal aspiration of the cyst was performed, which improved the clinical genitourinary symptoms. The maximal and mean urinary flow rates increased from 18 to 37 mL/s and from 6 to 16 mL/s, respectively.