Umemoto Susumu, Izumi Koji, Kita Kaoru, Kanno Hitomi
Department of Urology, Toshibarinkan Hospital.
Hinyokika Kiyo. 2007 Jan;53(1):71-4.
A 56-year-old woman was referred to our hospital presenting with urinary retention. Ultrasonography revealed bilateral hydronephrosis and magnetic resonance imaging of the pelvis showed diffuse thickening of the bladder wall. The hydronephrosis was improved by urethral balloon catheter. A cystoscopic examination revealed papillary lesions, polypoid yellow lesions and gross mucosal edema in the whole bladder. Pathological examination of transurethral punch biopsy showed no malignancy but inflammatory infiltration in the submucosa of bladder wall with many eosinophils. She performed clean intermittent self-catheterization and was treated with corticosteroids and antihistaminics. Three months after diagnosis, conservative treatment resulted in an excellent relief of symptoms, decrement of residual urine and remission of the bladder lesions in cystoscopy. In women with urinary retention, eosinophilic cystitis (EC) must be considered in the differential diagnosis. To our knowledge, this is the first case of EC presenting with urinary retention reported in the Japanese literature.
一名56岁女性因尿潴留转诊至我院。超声检查显示双侧肾积水,盆腔磁共振成像显示膀胱壁弥漫性增厚。经尿道气囊导管置入后肾积水有所改善。膀胱镜检查发现全膀胱有乳头状病变、息肉样黄色病变及明显黏膜水肿。经尿道穿刺活检的病理检查显示无恶性病变,但膀胱壁黏膜下层有炎症浸润,可见许多嗜酸性粒细胞。她接受了清洁间歇性自家导尿,并接受了皮质类固醇和抗组胺药治疗。诊断后三个月,保守治疗使症状得到了显著缓解,残余尿量减少,膀胱镜检查显示膀胱病变缓解。对于有尿潴留的女性,鉴别诊断时必须考虑嗜酸性膀胱炎(EC)。据我们所知,这是日本文献中报道的首例以尿潴留为表现的EC病例。