A 40-year-old woman was seen in our clinic in March 2002 for recurrent urinary tract infections with pyelonephritic symptoms in 2001 and a finding of a 'polyps' bladder in recent gynecological ultrasound.
Upon interrogation, no remarkable personal pathological antecedents were found, except for the reference of lumbosacra anomaly ( spina bifida and sacral agenesis) without specific therapeutic action later on.
The only significant family history was a mother with 'polycystic kidney disease' without other associated diseases.
The patient was studied with the following results:
- general physical illness: severe tapeworm.
urethral symptoms: normal lumboabdominal inspection.
No palpable kidneys, negative percussion.
painful pyeloureterals
Hypogastrium normal to palpation.
Normal urethra.
External genitalia without alterations and absence of genitourinary glands.
Stress test (Mashall-Bonney) negative.
- bleeding and hemochemistry: normal (creatinine at 0.8 dg/ml and blood glucose at 88 mmol/l).
- Urine leakage: density in 1020, pH 5, leucocyturia (15-20 l/c), 2-3 ht/c, and marked bacteriuria in sediment.
- Urocultive: Echerichia Coli (mas 100 000c/ ml).
- Abdominal ultrasound: normal kidneys and other intra-abdominal organs, except for multi-site bladder.
- intravenous urography: space 'empty' from L4-L5 vertebrae with dysraphism or bifidence and absence of sacral vertebrae.
Morphology and renal function were bilaterally normal, without ureteral anomalies.
Piriform axe, or 'abeto', multiparous.
No vesicoureteral reflux.
Post-voidance radiological significance.
- Urodynamic study: no evidence of urinary incontinence due to 'contrast non-hybid' or 'stress'.
Hypocalcium sealant with moderately diminished adaptability, without affecting bladder capacity or post void residual.
- Confirmed bladder ultrasound in consultation: Absence of bladder recurrence.
Subsequent urological management: treatment of bacteriuria with norfloxacin.
Monthly monitoring with general urine analysis.
Quarterly urocultive.
Annual general urological control.
Consequent attitude with results.
Ev: occasional voiding discomfort (once or twice a year) that disappears with antibiotic monodose.
Control studies were negative.
