Ultrasonography of urinary tract lesions caused by bilharziasis in Yemeni patients.

OBJECTIVE

To evaluate abnormalities detected by ultrasonography in Yemeni patients with active Schistosoma haematobium infection.

PATIENTS AND METHODS

As part of a co-operation between a private hospital and the Schistosomiasis Control Project in Yemen, laboratory and ultrasonographic examinations were undertaken in 158 patients (eight female, 150 male, mean age 17 years) with active S. haematobium infection. Upper urinary tract dilatation, lower ureteric changes and bladder wall abnormalities (thickness, hyper-echogenicity and polypoid lesions) were recorded. Laboratory findings and ultrasonographic changes were evaluated and categorized according to the age of the patients.

RESULTS

Twenty-eight patients (18%) showed no morphological lesion on ultrasonography. Bladder abnormalities (thickness, hyper-echogenicity and polypoid lesions) were found in 130 patients (82%) and upper tract lesions in 86 (54%). There were no upper tract lesions seen without an associated bladder abnormality. There were polyps within the lower ureteric lumen in four patients; in these patients there was a higher incidence of severe infection. One patient had a urinary bladder tumour.

CONCLUSION

Urinary bilharziasis has typical ultrasonographic features, but may occur with no morphological lesion detectable on ultrasonography. Upper tract lesions seem to develop only with lower tract abnormalities.