2006, Number 1
Cistitis glandular y polipoide con metaplasia de urotelio prostático y nidos de Brunn
Francolugo VVA, Ortega MCO
Full text
Language: Spanish
References: 7
Page: 26-32
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ABSTRACT
One case of glandular polipoide cystitis is presented. Glandular cystitis is a proliferative non common injury and turns into a cilindric snot producer epithelium located inside bladder’s mucous and submucous. It’s been found in all age patients with low incidence (less than 1%). It’s believed that it is part of a great number of bladder proliferative injuries being formed as an inflammation reaction This includes Brunn nets, cystic cystitis, follicular and glandular cystitis.2,3 In patients with pelvic lipomatosis, there is a high incidence of glandular cystitis, considered by some, as a premalign injury as reported by Edwards et al in 1972, where a glandular cystitis evolve to an adenocarcinoma.Case report
17 years old male, appear in the hospital referring a month ago a “mass in hypogastrium” hematuria, unrecognized difficulty to urinate that is strange for parents so they came to emergency department.
During exploration bladder was full with urine, draining 1200 ml approximately. Patient brought with him a US (carried out a day before) where clots and bilateral hidronefrosis were present in bladder. High urinary retention and some prostatitis data.
Urodynamic study was requested and reported 1 000 ml of residual urine, very low propioceptiv sensibility, maximum cistometric capacity 642 ml with 50 cm of water pressure. Non inhibited shonkages present with low pressure and coincident electromiographic activity.
Cistometric emptiness: spontaneous micction retarded (Qmax only 5ml/seg). Detrusor pressure of 91 cm of water with no electromiographic silence, but a little but influenced by abdominal press. Urodynamic diagnostic: bladder-sphincter disinergia, suggesting neurological valuation and intermittent catheter. We continuous him studies with control US, excretorial urography, neurological valuation and cistography. US reported renal cavities distended with some inflammation process data, effort bladder with pseudo diverticles and intravesical growth (tumoration) image. Excretorial urography reported renal cavities lightly distended endeavour/effort bladder and inconspicuous filling faults. Neurological assessment was normal.
Cistographic study corroborates an effort bladder, traveculated bladder and pseudo diverticles with no vesicouretral reflux. Cistoscopy shows a bladder that was sesil (pediculated), was initiated in the prostatic ureter very close to trigono of 4 to 5 cm approximately. This batter was completely blocking vesical collar.
A tumoration transuretral resection was carry out and the histopathology result was glandular and polypoide cyst with prostatic urotelio metaplasia and Brunn nests.
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