A 36-year-old woman was referred with
urinary incontinence and recurrent episodes of
pyelonephritis. Two years prior to her visit, she underwent transurethral resection of a
bladder tumor, 5 cm in diameter. Total
cystectomy was suggested, as the initial diagnosis was
sarcoma. Close re-evaluation of the pathological specimen lead to the final diagnosis of a benign
inflammatory pseudotumor of the bladder as the
tumor consisted of smooth muscle cells with white blood cell infiltration but without mitotic figures. The
tumor disappeared during the follow up period. A cystography revealed bilateral
vesicoureteral reflux with marked trabeculated bladder. A cystometry showed loss of bladder sensation and a low compliance bladder without detrusor contraction. Neurological examination and a magnetic resonance imaging of the spinal cord failed to prove the presence of definite neurological abnormalities. She was finally diagnosed with
neuropathic bladder of unknown origin. In this case, she had been suffering from recurrent
cystitis about 6 years before the resection of
bladder tumor and it was suggested that the occurrence of the
inflammatory pseudotumor of bladder would be related with chronic
urinary tract infection due to
neuropathic bladder.
Urinary incontinence and
urinary tract infection were controlled successfully with clean intermittent self-catheterization and adequate administration of antimicrobial drugs.
Vesicoureteral reflux was treated with injection of
GAX collagen into the ureteral orifices. No
tumor recurrence has been found up to the present time, 5 years after the resection of
bladder tumor.