Eosinophilic cystitis with recurrent urinary retention: case report

Abstract

Eosinophilic cystitis is a rare inflammatory disease of the bladder whose origin, pathogenesis, and treatment are unknown. Frequency, dysuria, and hematuria are frequent symptoms. Here, we report a rare occurrence of recurrent urinary retention and repetitive catheterization. A 67-year-old male presented with acute urinary retention and intermittent gross hematuria of 2 weeks duration. Urethral catheterization followed by a trial without catheter, was successful. Complete blood count showed presence of eosinophils (eosinophilia) and computed tomography of kidneys, ureter and bladder with contrast showed thickened bladder wall and small prostate. Cystoscopy revealed an erythematous lesion over the anterior wall. The rest of the mucosa was normal. Transurethral biopsies of the lesion were performed and histologic examination showed features of eosinophilic cystitis. Despite multiple medication regimens containing corticosteroids and antihistamines, he presented with recurrent urinary retention, approximately once every month. After 6 months, he was started on bethanechol, which led to no catheterization for up to 2 years. To the best of our knowledge, this is the first report on the successful use of bethanechol as a treatment for eosinophilic cystitis with recurrent urinary retention.

Eosinophilic cystitis in children: A case report

“…During hospitalization, the eosinophils were found to be decreased in a routine blood test and the patient's symptoms gradually improved. It has previously been suggested that EC may also present a self-healing trend ( 3 ). In the present study, patient 1 presented with similar symptoms 3 years earlier; an ultrasonography revealed thickening of the bladder wall and following 3 days of anti-inflammatory treatment, the symptoms disappeared.…”

“…In addition, patient 1 was allergen-positive. The authors hypothesize that the onset of the disease in case 1 was associated with allergens and that, with the elimination of inflammatory mediators, symptoms may disappear ( 3 ). It has previously been reported that urine cultures are positive in EC patients ( 4 ).…”

“…As for children, adults are rarely affected by EC. Incidence in males is larger compared with females and onset develops at a mean age of 6.0±0.5 years ( 3 , 4 ). EC has been reported to be local manifestations of systemic ‘hypereosinophilic’ syndromes and allergic diseases, and is associated with bladder trauma, infections and certain medications, including iodine or anesthetic ointments ( 5 , 6 ).…”

Diagnostic et prise en charge des cystites à éosinophiles

“…Sur le plan clinique, La symptomatologie de la CE est polymorphe et non spécifique. Les symptômes les plus fréquents étaient la pollakiurie (67%), la dysurie (62%), l'hématurie macroscopique ou microscopique (68%), la douleur sus-pubienne (49%) et la rétention aiguë d'urine (10%) [6, 9]. Chez les enfants, la CE peut se manifester par une énurésie secondaire [10].…”

Clinicopathological characteristics and outcomes of eosinophilic cystitis: A retrospective study

“…Eosinophilic cystitis (EC) is a rare inflammatory disorder of the bladder whose etiology, pathogenesis, and treatment are unknown. The reported frequent symptoms of this disease include frequency, dysuria, and hematuria [ 1 ]. Although the etiology of EC is unclear, allergies or injuries of the bladder wall appear to be present in most patients [ 2 ].…”