Alamer Mohammed F, Alhuthaly Saud K, Alfahhad Mohanned F, Taher Hussein O, Gazzaz Raneem Y, Miliany Tuleen T, Alsulaiman Abdullah S, Almohaimeed Latifah Y, Almadwi Rabab S, Qadah Zeyad A, Alfaqih Omar M, Alshammari Raed K, Alsharif Eid M, Al-Dablan Mohammed S, Al-Hawaj Faisal
College of Medicine, Batterjee Medical College, Jeddah, SAU.
College of Medicine, Umm Al-Qura University, Mecca, SAU.
Cureus. 2021 Nov 24;13(11):e19878. doi: 10.7759/cureus.19878. eCollection 2021 Nov.
Urge incontinence is the most frequent type of urinary incontinence that can be due to bladder outlet obstruction or overactive bladder. A focused history is crucial to identify the type of urinary incontinence and the possible etiology. We report the case of a 67-year-old man with urinary frequency, urgency, and nocturia. However, his urine stream is normal with no history of an intermittent stream, hesitancy, or postvoid dribbling. Digital rectal examination revealed normal prostatic size. Urinalysis results were normal. Urine culture showed no growth. The patient was prescribed symptomatic treatment in the form of anticholinergic medication but failed to provide any clinical improvement. Urodynamic studies suggested the diagnosis of detrusor instability. A computed tomography (CT) scan of the abdomen was performed and demonstrated the presence of a large retroperitoneal lipoma exerting a mass effect on the bladder. The mass was successfully resected by laparotomy operation. Following the operation, the patient had complete resolution of his symptoms. The retroperitoneal region is an extremely rare site for lipoma. Patients with urinary urgency should be carefully evaluated for any structural lesion causing a compressive effect on the bladder.
急迫性尿失禁是最常见的尿失禁类型，可能由膀胱出口梗阻或膀胱过度活动症引起。详细的病史对于确定尿失禁的类型和可能的病因至关重要。我们报告一例67岁男性，有尿频、尿急和夜尿症状。然而，他的尿流正常，无间歇性尿流、排尿犹豫或排尿后滴沥史。直肠指检显示前列腺大小正常。尿液分析结果正常。尿培养无细菌生长。患者接受了抗胆碱能药物的对症治疗，但未取得任何临床改善。尿动力学研究提示诊断为逼尿肌不稳定。进行了腹部计算机断层扫描（CT），显示存在一个巨大的腹膜后脂肪瘤，对膀胱产生占位效应。通过剖腹手术成功切除了肿块。术后，患者症状完全缓解。腹膜后区域是脂肪瘤极为罕见的发生部位。对于有尿急症状的患者，应仔细评估是否存在对膀胱产生压迫作用的任何结构病变。
