Cystitis cystica and glandularis producing large bladder masses in a 16-year-old boy

Abstract

The macroscopic appearances of florid cystitis cystica et glandularis can be mistaken for malignancy, and it is therefore important to perform a prompt resection to confirm the histological diagnosis and exclude sinister pathology.

Cystitis Cystica – Chronic Urinary Bladder Inflammation in Children

“…Treatment of cystitis cystica is difficult and long-lasting. Oral administration of furazidine and trimethoprim with sulfamethoxazole, and local treatment with intravesical infusions of antibiotics (gentamicin) and corticosteroids (prednisone) are used [1,2,5,6,8,12].…”

“…The most common form of chronic cystitis in children is cystitis cystica, diagnosed in approximately 10% of patients with UTI [1,7], with an 80% female predominance [8]. Endoscopic examination of the lower urinary tract shows small, pearly, pink, brown, or yellow cysts within the mucosa.…”

“…The pathogenesis of cystitis cystica is unclear. The changes originate from the urothelial buds, which tuck into the submucosa and form the so-called Brunn's nests within the lamina propria, which then degenerate into a cystic form with the appearance of luminal mucin [2,5,8]. They do not penetrate the muscularis propria of the urinary bladder [7].…”

“…Clinically, inflammation may be asymptomatic or manifest with symptoms of active infection. Chronic inflammation may lead to urinary incontinence, urgency, increased daytime urinary frequency, dysuria, and even urinary retention [2,3,5,6,8,9,11]. Detrusor overactivity, reduction in urinary flow rate, irregular patterns of urine flow and residual urine after voiding which further predisposes to infection, may be found in urodynamic tests [3,5].…”

Images – A rare case of Brunn’s cyst causing obstructive lower urinary tract symptoms in a young male

“…5 In these patients, inflammatory cells are commonly seen on urine cytology and the bladder mucosa has an inflammatory appearance. 6 Cystitis glandularis is also associated with chronic inflammation leading to glandular metaplasia. Cystitis glandularis can also cause hematuria and has been reported to cause acute urinary retention.…”