Interstitial cystitis has been thought to result from autoimmune phenomenon and its ocurrence in systemic lupus erythematosus(SLE)has rarely been reported. We report a case of female patient with SLE whose initial urinary symptoms were caused by intersitial cystitis. Radiography showed the reduced bladder capacity, irregularity of bladder wall, hydronephrosis and hydroureter. Deep bladder wall biopsy was performed and a diagnosis of interstitial cystitis with SLE was made. She was treated with steroid and stent insertion and showed symptomatic improvement. We consider the recognition of bladder involvement in systemic lupus erythematosus is important because it may be a reversible cause of renal failure in a patient with lupus erythematosus and adequate therapy may preserve bladder size and function.
Biopsy ; Cystitis ; Cystitis, Interstitial* ; Diagnosis ; Female ; Humans ; Hydronephrosis ; Lupus Erythematosus, Systemic* ; Radiography ; Renal Insufficiency ; Stents ; Urinary Bladder

Retroperitoneal fibrosis was first described in 1905 by Albarran, a French urologist, who performed ureterolysis for ureteral compression produced by the disease. However, this disease became an established clinical entity by Ormond's account in the English literature in 1948. Pericystitis plastica has been used the define an extremely rare type of Idiopathic retroperitoneal fibrosis (IRF) constricting the bladder. In this study, we discussed the recovery of 29-year-old woman with pericystitis plastica who was misdiagnosed as pelvic malignancy or a chronic/subacut pelvic inflammation at the first evaluation.
Adult ; Cystitis/*radiography ; Diagnosis, Differential ; Female ; Human ; Pelvic Inflammatory Disease/*radiography ; Pelvic Neoplasms/*radiography ; Retroperitoneal Fibrosis/*radiography ; *Tomography, X-Ray Computed

Emphysematous cystitis is rare disease associated with gas in the bladder wall and lumen. Presentation is varied and sequelae may be minor, severe or fatal. Treatment consists of administration of appropriate antibiotics, control of blood glucose, and adequate bladder drainage. We present a case of emphysematous cystitis with diabetic woman, who did not present symptoms of cystitis but abdominal pain, nausea and vomiting. In our case, it was detected incidentally on simple radiography. After administration of susceptible parenteral antibiobcs and control of blood glucose level, her symptoms were improved.
Abdominal Pain ; Anti-Bacterial Agents ; Blood Glucose ; Cystitis* ; Drainage ; Female ; Humans ; Nausea ; Radiography ; Rare Diseases ; Urinary Bladder ; Vomiting

OBJECTIVES: To investigate the etiologies of urinary bladder involvement in patients with systemic lupus erythematosus (SLE), the clinicoradiologic features of gastrointestinal tract manifestations and clinical outcomes in patients with lupus cystitis accompanied by gastrointestinal manifestations. METHODS: We conducted a retrospective chart review on 413 patients with SLE. Patients were selected for review on the basis of lower urinary tract symptoms including urinary frequency, urgency and urinary incontinence. Radiologic studies were analyzed in patients with lupus cystitis. RESULTS: Ten consecutive patients, complicated with lower urinary tract symptoms, were identified. Underlying etiologies were as follows: lupus cystitis in five, neurogenic dysfunction secondary to transverse myelitis in three, cyclophosphamide-induced cystitis in one and tuberculous cystitis in one patient. All patients with lupus cystitis showed gastrointestinal manifestations, such as abdominal pain, nausea, vomiting and/or diarrhea during the periods of cystitis symptoms. In all patients with lupus cystitis, paralytic ileus was demonstrated on plain abdominal X-ray and ascites, bilateral hydroureteronephrosis and thickened bladder wall were identified on abdominal ultrasound or CT. Abdominal CT revealed bowel wall thickening in four of the five patients. The main sites of thickened bowel on abdominal CT were territory supplied by superior mesenteric artery. Two of five patients with lupus cystitis expired during the follow-up period. CONCLUSION: Diverse etiologies may cause lower urinary tract symptoms in patients with SLE. Lupus cystitis is strongly associated with gastrointestinal involvement and abdominal CT can be a useful radiologic tool to investigate the gastrointestinal tract involvement in patients with lupus cystitis.
Adolescence ; Adult ; Cystitis/radiography ; Cystitis/etiology+ACo- ; Cystitis/epidemiology ; Female ; Gastrointestinal Diseases/radiography ; Gastrointestinal Diseases/etiology+ACo- ; Gastrointestinal Diseases/epidemiology ; Human ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/complications+ACo- ; Male ; Middle Age ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Assessment ; Tomography, X-Ray Computed

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography