Acute Urine retention in adolescent is uncommon presentation. Infection, trauma are the most common etiology on this age group. Simple work up and management can be concluded in family medicine clinic without urology reference.
Zinner’s syndrome (ZN) is rare syndrome. It is presented usually with fertility problem and ejaculatory complaints on adults.  Unusual early presentation of ZN in such age group with urological symptoms rather than fertility complaint is addressed in our case. Furthermore acute urine retention in ZN is not listed in literature.  
Herein, the case is presented as urine retention first leading sign of syndrome diagnosis in such age.  Endoscopic management was carried out with successful outcome.

A boy 17 – Years old presented to emergency with left testicular pain and failure to pass urine of 6 hours duration. He had no urological history. He denied testicular trauma. 
On Ultrasound the bladder was full with cystic like swelling on left side of prostate compressing urethral lumen, there was agenesis of left kidney with Normal right renal unit. Normal testis with preserved vascularity had been proven as well. Fixation of urethral catheter was done, with immediate passage of 600 cc of clear urine.
Later, MRI abdomen and pelvis with contrast was done. A large left seminal vesicle of cystic nature, turbid content, Dilated left ejaculatory duct was detected. Normal right renal unit with agenesis of left unit was clearly observed. Picture is suggesting ZN.
Examination under anesthesia there was asymmetrical lobes of prostate. A soft palpable rounded swelling on left side at base of prostate. Cystoscopy show bulge on left prostatic urethra extending to the bladder neck, that shifting the urethra to right side and compromised its diameter significantly.
Using LASER cutting-mode, slit like incision was created distal to bladder neck by 1 cm extending distally to near Veru montanum. It was deepening gradually until cyst was opened and a turbid cloudy fluid was expelled out. Manual augmented compression of the cyst rectally.

After couple of day, catheter was removed, patient was satisfied, voiding spontaneously without difficulty. Pelvic Ultrasound was done and marked reduction of cyst size and no compression on bladder neck. No further testicular pain.

Herein, the case is presented as a first leading sign of syndrome diagnosis in such age.  Endoscopic management was carried out with successful outcome.

Don’t humble any complaint. A simple sign in such age group, as it could link to hidden pathology. Rather than endoscopic minimal invasive surgical option could be a safe intervention and could relieve the obstruction of the ejaculatory duct by time.