Division of Urology, University Hospital "Ospedali Riuniti", School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona.
Department of Urology, Civitanova Marche Hospital, Civitanova Marche.
Arch Ital Urol Androl. 2022 Sep 27;94(3):350-354. doi: 10.4081/aiua.2022.3.350.
The aim of the study is to make a review of the literature about bladder malakoplakia.
We searched articles on the PUBMED web-literature database with the following keywords: "vesical malakoplakia" and "bladder malakoplakia". In the literature we found 254 articles. At final we have excluded 219 articles, including in our study only 35 articles.
The overall average age found was 50.85 years. The average age of men was 43.22 years, while that of women was 53.37 years. 75% of the patient cases were women and 25% were men. Regarding comorbidities, in 5.55% of the cases were missing whereas 47.22% of the patients suffered from recurrent urinary tract infection (UTI) and 19.44% from immune system disorders. Urine culture was positive in 69.44% with E.coli being isolated in 92% of cases. Hydroureteronephrosis was present in 44.44% of the cases: left in 6.25% of cases, right in 18.75% and bilateral in 75%. The mean serum creatinine of patients with hydroureteronephrosis was 5.11 (1-21) mg/dl. The most frequent site of the lesion was the vesicoureteral junction (VUJ) (42.31%), followed by the trigone (38.46%). 30.56% of patients were treated with antibiotic and surgery (transurethral resection of bladder, partial or radical cystectomy), less frequent options were antibiotics alone and surgery alone. The recurrence rate was 15%.
Malakoplakia is a disorder usually related to other affections, like UTI and immunodepression, and it seem to be caused by an abnormal macrophage function. In almost half of the described cases of isolated bladder malakoplakia, hydroureteronephrosis and renal failure were present.Treatment is not standardized, but both medical and surgical therapies are effective to avoid recurrence.
本研究旨在对膀胱黏膜性肥厚症的文献进行综述。
我们在 PUBMED 网络文献数据库中使用以下关键词搜索文章：“vesical malakoplakia”和“bladder malakoplakia”。在文献中，我们共找到了 254 篇文章，最终排除了 219 篇，仅纳入了 35 篇文章进行研究。
总体平均年龄为 50.85 岁。男性的平均年龄为 43.22 岁，而女性的平均年龄为 53.37 岁。75%的患者为女性，25%为男性。关于合并症，有 5.55%的病例缺失，47.22%的患者患有复发性尿路感染（UTI），19.44%的患者患有免疫系统疾病。尿液培养阳性率为 69.44%，其中 92%的病例分离出大肠杆菌。44.44%的患者存在输尿管积水，其中左侧 6.25%，右侧 18.75%，双侧 75%。有输尿管积水的患者的平均血清肌酐为 5.11（1-21）mg/dl。病变最常见的部位是膀胱输尿管连接部（VUJ）（42.31%），其次是三角区（38.46%）。30.56%的患者接受了抗生素和手术（经尿道膀胱切除术、部分或根治性膀胱切除术）治疗，较少采用的方法是单独使用抗生素和单独手术。复发率为 15%。
黏膜性肥厚症通常与尿路感染和免疫抑制等其他疾病有关，似乎是由异常的巨噬细胞功能引起的。在描述的孤立性膀胱黏膜性肥厚症病例中，近一半存在输尿管积水和肾功能衰竭。治疗方法不规范，但药物和手术治疗均能有效避免复发。
