Acute urinary retention due to benign prostatic hyperplasia associated with cystitis glandularis in a 22-year-old patient

Abstract

A 22-year-old man has consulted in emergency for acute urinary retention and left renal colic. Bladder catheterization was performed. Symptomatic treatment was provided with no improvement. MRI showed a pseudotumoral bladder wall thickening associated with vesical floor budding with prostate median lobe infiltration. The patient got an endoscopy that concluded to an inflammatory aspect of the bladder mycosa and a solid mass in the bladder neck arising. The biopsy during examination concluded to a glandular cystitis. Ultrasonography performed six months later still showed an enlarged prostate of 60g volume, post void residue of 280ml and bilateral hydronephrosis. A second cystoscopy showed an obstructive prostate with a median lobe. A transurethral resection of this lobe was performed. The pathological examination concluded to a benign prostate hyperplasia. This case is likely to be the first reported so far about a BPH in a young male associated with Cystitis Glandularis. Neither etiology nor evidence of the cause behind this case has been identified so far. Although Benign Prostate Hypertrophia is rare among young males, its ethiopathogenesis is not well known, its relation with cystitis glanduralis in young patients has never been described before. Both medical and surgical approaches remain similar to the adults.

The Efficacy and Safety of Transurethral 2 μm Laser Bladder Lesion Mucosal En Bloc Resection in the Treatment of Cystitis Glandularis

“…And these symptoms are prone to recurring. In severe cases, acute urinary retention mayoccur ( 7 ). For the treatment of glandular cystitis, some people advocate conservative treatment such as the use of quinolone antibiotics and cyclooxygenase-2 inhibitors ( 3 ).…”

Studi Kasus Benign Prostatic Hyperplasia (Bph)

“…Direkomendasikan menggunakan terapi Alpha blockers dan/ atau 5-alpha reductase inhibitors (Alfuzosin 10 mg PO dan dutasteride 0,5 mg PO). Dalam kasus kegagalan perawatan medis, atau komplikasi seperti retensi urin akut, ISSN 2301-5977, e-ISSN 2527-7154 https://journal.unram.ac.id/index.php/LJU/index infeksi saluran kemih, atau lithiasis kandung kemih, operasi endoskopi atau prostatektomi terbuka dapat dilakukan tergantung pada volume prostat (Zouari et al, 2018). Pemberian kombinasi alfuzosin dan dutasteride karena dapat memberikan efek sinergis antara manfaat kedua obat, sehingga dapat menghasilkan terapi yang lebih baik.…”

Cystitis Cystica and Cystitis Glandularis of the Urinary Bladder: A Review and Update

“…Zouari et al [44] reported a 22-year-old man, who did not have any past medical history, who had consulted in emergency for acute urinary retention and left renal colic. Bladder catheterization was undertaken as well as an ultrasound scan which showed left obstructive pre-meatus calculi of 6 mm and distension of his urinary bladder.…”

“…Upon examination the patient was found to be afebrile and a slight tenderness on the left flank was found upon his abdominal palpation. Upon digital examination (DRE), Zouari et al [44] found an enlarged prostate gland; there were no indurations and no areas of softness or tenderness within the prostate gland found during the examination. An anti-inflammatory and antalgic treatment was provided to the patient.…”

“…An anti-inflammatory and antalgic treatment was provided to the patient. After one week, Zouari et al [44] removed the urethral catheter but the patient was still having dysuria. Another ultrasound scan was undertaken; there was an inflammatory aspect of the bladder noted with a thickened bladder wall and a tissular proliferation that measured 5*2 cm on the bladder neck and at the left wall with large implantation and probably prostate infiltration.…”