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Cystoprostatectomy with ileal neobladder for treatment of severe cystitis glandularis in an AIDS patient.

Coelho RF, Marchini GS, Dall'oglio MF, Medeiros MT, Nesrallah AJ, Srougi M - Clinics (Sao Paulo) (2008)

View Article: PubMed Central - PubMed

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Cystitis glandularis (CG) is a proliferative and metaplastic disorder of the bladder urothelium that usually occurs when the bladder mucosa becomes hyperproliferative in the presence of chronic inflammation and nests of urothelium appear within the lamina propria... CG is rarely reported in children; even in adults, its incidence and clinical significance are not well known... It is generally a microscopic finding subsequent to cystoscopy and biopsy in a patient with irritative bladder symptoms or hematuria. – Most patients do not require more aggressive surgery options, and sparse literature is available regarding the management of severe CG... Microscopic analysis confirmed chronic CG all along the bladder urothelium (Figure 3)... CG is a benign proliferative disease of the bladder mucosa... If an etiology such as chronic infection is identified, it must be appropriately treated... In the reported case, no urinary infection or other causal factors were found... An associated risk of bladder cell carcinoma and adenocarcinoma has been reported– but is still debated... Although most patients with cystitis glandularis will never develop a malignant bladder lesion, it cannot be excluded that the most widely proliferative lesions may have premalignant potential... Intravesical BCG (bacillus Calmette-Guerin) application has been described as an adjuvant therapy after TURB for the treatment of cystitis glandularis... Ureteral obstruction is a rare complication that results from infiltration of the periureteral submucosa... It may be treated with ureteral reimplantation into the dome of the bladder in the presence of a contractile bladder, or may require temporary percutaneous nephrostomy, as was performed in our patient... Cystectomy with continent urinary diversion for cystitis glandularis has been very rarely reported., Obviously, such surgical procedures should be the last resort in these patients... Urinary diversion without cystectomy in such cases is considered to be ill-advised due to the possibility of persistent symptoms and the associated risk of adenocarcinoma.

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Intravenous urography showing bilateral ureterohydronephrosis and delayed contrast excretion. (150 minutes)
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f1-23-0008: Intravenous urography showing bilateral ureterohydronephrosis and delayed contrast excretion. (150 minutes)

Mentions: Urinary ultrasonography revealed a thickened bladder wall and a polypoid mass in the vesical trigone and prostatic urethra. Intravenous urography showed severe bilateral hydronephrosis and delayed contrast excretion (Figure 1). Computed tomography (CT) confirmed the thickening of the bladder wall and revealed bilateral distal ureteral thickening and dilatation up to the ureterovesical junction (Figure 2). Cystoscopy revealed a polypoid mass in the vesical trigone and prostatic urethra with an inflammatory aspect. The ureteral orifices were completely obstructed and therefore impossible to identify. An incomplete transurethral resection (TURB) of the lesion was performed. Histological study revealed chronic CG with the formation of an inflammatory polyp.


Cystoprostatectomy with ileal neobladder for treatment of severe cystitis glandularis in an AIDS patient.

Coelho RF, Marchini GS, Dall'oglio MF, Medeiros MT, Nesrallah AJ, Srougi M - Clinics (Sao Paulo) (2008)

Intravenous urography showing bilateral ureterohydronephrosis and delayed contrast excretion. (150 minutes)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664733&req=5

f1-23-0008: Intravenous urography showing bilateral ureterohydronephrosis and delayed contrast excretion. (150 minutes)
Mentions: Urinary ultrasonography revealed a thickened bladder wall and a polypoid mass in the vesical trigone and prostatic urethra. Intravenous urography showed severe bilateral hydronephrosis and delayed contrast excretion (Figure 1). Computed tomography (CT) confirmed the thickening of the bladder wall and revealed bilateral distal ureteral thickening and dilatation up to the ureterovesical junction (Figure 2). Cystoscopy revealed a polypoid mass in the vesical trigone and prostatic urethra with an inflammatory aspect. The ureteral orifices were completely obstructed and therefore impossible to identify. An incomplete transurethral resection (TURB) of the lesion was performed. Histological study revealed chronic CG with the formation of an inflammatory polyp.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Cystitis glandularis (CG) is a proliferative and metaplastic disorder of the bladder urothelium that usually occurs when the bladder mucosa becomes hyperproliferative in the presence of chronic inflammation and nests of urothelium appear within the lamina propria... CG is rarely reported in children; even in adults, its incidence and clinical significance are not well known... It is generally a microscopic finding subsequent to cystoscopy and biopsy in a patient with irritative bladder symptoms or hematuria. – Most patients do not require more aggressive surgery options, and sparse literature is available regarding the management of severe CG... Microscopic analysis confirmed chronic CG all along the bladder urothelium (Figure 3)... CG is a benign proliferative disease of the bladder mucosa... If an etiology such as chronic infection is identified, it must be appropriately treated... In the reported case, no urinary infection or other causal factors were found... An associated risk of bladder cell carcinoma and adenocarcinoma has been reported– but is still debated... Although most patients with cystitis glandularis will never develop a malignant bladder lesion, it cannot be excluded that the most widely proliferative lesions may have premalignant potential... Intravesical BCG (bacillus Calmette-Guerin) application has been described as an adjuvant therapy after TURB for the treatment of cystitis glandularis... Ureteral obstruction is a rare complication that results from infiltration of the periureteral submucosa... It may be treated with ureteral reimplantation into the dome of the bladder in the presence of a contractile bladder, or may require temporary percutaneous nephrostomy, as was performed in our patient... Cystectomy with continent urinary diversion for cystitis glandularis has been very rarely reported., Obviously, such surgical procedures should be the last resort in these patients... Urinary diversion without cystectomy in such cases is considered to be ill-advised due to the possibility of persistent symptoms and the associated risk of adenocarcinoma.

Show MeSH
Related in: MedlinePlus