Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.
Abdomen ; Actinomycosis/drug therapy/*pathology/surgery/ultrasonography ; Biopsy, Needle/methods ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Penicillins/therapeutic use ; Treatment Outcome ; Urinary Bladder/*pathology/surgery/ultrasonography ; Urinary Bladder Diseases/drug therapy/*pathology/surgery/ultrasonography

Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue. It is associated with multiple clinical conditions, such as collagen vascular diseases. It involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism, and this is often seen at sites of previous inflammation or damage. Potassium-titanyl phosphate (KTP) laser vaporization of the prostate is safe and relatively bloodless procedure that results in a shorter catheterization, immediate symptomatic improvement, and less severe postoperative irritative symptoms. However, longer follow-up studies or reports about complications are lacking. Here in we report a case of dystrophic calcification and stone formation on the entire bladder neck after performing KTP laser vaporization of benign prostate hyperplasia. That was treated by lithotripsy and transurethral resection.
Aged ; Calcinosis/*diagnosis/pathology ; Humans ; Lasers, Solid-State/*adverse effects ; Lithotripsy ; Male ; Prostatic Hyperplasia/*surgery ; Urinary Bladder Calculi/*diagnosis/etiology/ultrasonography ; Urinary Bladder Diseases/*diagnosis/etiology/ultrasonography

Catecholamines ; Cystectomy ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Paraganglioma ; diagnostic imaging ; pathology ; surgery ; Time Factors ; Ultrasonography ; Urinary Bladder ; diagnostic imaging ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology ; surgery

PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.
Constriction, Pathologic/*diagnosis ; Humans ; Hydronephrosis/diagnosis ; Kidney/ultrasonography ; Prospective Studies ; Risk Factors ; Ureter/*pathology/ultrasonography ; Ureteral Calculi/*therapy ; Ureterolithiasis/*surgery ; Ureteroscopy/*adverse effects ; Urinary Bladder/ultrasonography

A 59-year-old Korean man complained of a painless scrotal hard nodule and weak urine stream. The ultrasound scan revealed a 2.2-cm sized round heteroechogenic nodule located in the extratesticular area. Microscopic hematuria was detected in routine laboratory examinations. On scrotal exploration, multiple spargana were incidentally found in the mass and along the left spermatic cord. On cystoscopy, a 10-mm sized mucosal elevation was found in the right side of the bladder dome. After transurethral resection of the covered mucosa, larval tapeworms were removed from inside of the nodule by forceps. Plerocercoids of Spirometra erinacei was confirmed morphologically and also by PCR-sequencing analysis from the extracted tissue of the urinary bladder. So far as the literature is concerned, this is the first worm (PCR)-proven case of sparganosis in the urinary bladder.
Animals ; Cystoscopy ; DNA, Helminth/chemistry/genetics ; Hematuria/diagnosis ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Scrotum/*parasitology/*pathology/ultrasonography ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Sparganosis/*diagnosis/parasitology ; Spirometra/*isolation & purification ; Urinary Bladder Diseases/*parasitology/*pathology/surgery