膀胱頸囊性腺性膀胱炎造成膀胱出口阻塞之案例報告

張乃文¹、陳順郎^1,2,3

¹中山醫學大學附設醫院 泌尿科， ²醫學院， ³醫學研究所

Bladder outlet obstruction caused by cystitis cystica et glandularis at bladder neck

Nai-Wen Chang¹, Sung-Lang Chen^1,2,3

Department of Urology¹, School of Medicine² and Institute of Medicine³, Chung Shan Medical University Hospital, Taichung, Taiwan

Introduction: We presented a case of cystitis cystica et glandularis located at bladder neck causing bladder outlet obstruction (BOO). Cystitis cystica et glandularis is a rare proliferative disease and presents rarely as a large visible lesion of urinary bladder.

Case presentation: A 44-year-old man had dysuria for about 1 month, accompanied with LUTS. Uroflowmetry suspected BOO. Sonography revealed much residual urine and a small tumor in bladder. Cystoscopy showed anterior bladder neck with protruding mass causing obstruction and much vesical stones. Video-urodynamic study showed bladder neck not opening with high detrusor pressure and much PVR. The surgical finding showed redundant mass at 12 o-clock of bladder neck and the pathology reported cystitis cystica et glandularis at bladder neck.

Discussion: Transurethral resection is an effective management and extensive surgical margin may be needed in severe and recurrent cases. Some risk factors related to recurrence include UTI, long-term foley catheter indwelling, urolithiasis, and squamous metaplasia. Following up closely by cystoscopy with biopsies is recommended owing to the risk of progression to malignancy.

Conclusion: Cystitis cystica et glandularis is a rare disorder occurring at bladder neck, causing BOO. The outcome of surgical management is excellent. It is crucial to follow up regularly and avoid associated risk factors of recurrence.