Cistite glandular evoluindo com uropatia obstrutiva

Lopes, Humberto Elias; Bolognani, Carlos Eduardo Dainezzi; Roberti, Fabiane Corbelli; Dentz, Leonardo Cunha; Recaverren, Fernando E.Q.

doi:10.1590/s0101-28002009000400009

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“…1 Lopes et al reported a case of a 55-year-old man with recurrent cystitis glandularis with bilateral hydroureteronephrosis who underwent cystoprostatectomy with an ileal neobladder after two transurethral resections done for recurrence. 18 Hu et al studied 278 patients with cystitis glandularis with 59.3% of patients experiencing recurrence, and developed a normogram to predict the individualised recurrence by integrating urinary infection, long-term indwelling catheter, urinary calculus, squamous metaplasia, atypical hyperplasia and intestinal subtype. 19 Although we did not study predictive factors for recurrence owing to a limited sample size, eight patients had recurrent lesions and two of the patients had to undergo major surgery in the subsequent follow-up.…”

Section: Discussionmentioning

confidence: 99%

Understanding an unusual urothelial disorder: cystitis cystica et glandularis

Garg

Singh

Nayak

et al. 2021

Journal of Clinical Urology

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Objectives: To study the presentation and natural course of cystitis cystica et glandularis. Methods: A retrospective analysis of patients with histopathologically confirmed cystitis cystica et glandularis from March 2016 to March 2018 who at least completed their 2 years’ follow-up was performed. Perioperative details along with the last available follow-up were included in the analysis. Results: A total of 10 patients were included. The mean age (± standard deviation) was 33.4 (±14.0) years and nine (90%) were men. The most common presentation was storage and voiding lower urinary tract symptoms (80%) along with haematuria (40%) and dysuria (20%). Four patients had the presence of hydronephrosis in preoperative imaging, of which three patients had bilateral mild hydroureteronephrosis. All the patients underwent transurethral resection of the bladder tumour as all were diagnosed with urinary bladder mass on preoperative imaging. All the patients had a trigonal lesion with a bullous appearance partially obstructing the bladder neck. Six patients underwent double J stenting in the perioperative period. The mean (± standard deviation) follow-up duration was 32.8 (±7.5) months. Patients were kept on regular surveillance with imaging and cystoscopy as indicated. Eight patients (80%) developed recurrence in the follow-up period. The mean number of recurrences was 1.5 (±1.1). One of the patients had to undergo augmentation ileocystoplasty with bilateral ureteric reimplantation because of the recurrent lesion with small contracted bladder, while another patient underwent cystectomy with urinary diversion owing to recurrence and refractory lower urinary tract symptoms. Besides, there was no evidence of malignancy after this entity in any of the patients. Conclusion: Cystitis cystica et glandularis is a rare clinic pathological entity which often mimics bladder tumour. Cystitis cystica et glandularis is common in men and often presents with lower urinary tract symptoms. Transurethral resection forms the mainstay of treatment. However, it is often associated with upper tract hydronephrosis. Its controversial premalignant nature compounded with recurrence and risk of upper tract deterioration warrants close surveillance. Level of evidence: 4

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Section: Discussionmentioning

confidence: 99%