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Ambrosini F, Riccardi N, Occhineri S, Matucci T, Paraboschi I, Calarco A, Berrettini A, Tiseo G, Canetti D, Van Der Merwe A, Terrone C, Mantica G. Uncommon Haemorrhagic Cystitis of Infectious Origin: A Narrative Review for Urologists. Res Rep Urol 2023; 15:365-373. [PMID: 37564174 PMCID: PMC10411501 DOI: 10.2147/rru.s412278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose Haemorrhagic cystitis may be due to different etiologies with infectious diseases representing an insidious cause to diagnose. The aim of this narrative review is to provide a comprehensive overview of less common but difficult-to-diagnose causes of infectious haemorrhagic cystitis of bacterial, mycobacterial, and parasitic origin, Moreover, we highlight possible diagnostic tools and currently available treatment options in order to give an updated tool for urologists to use in daily practice. Patients and Methods The search engine PubMed was used to select peer-reviewed articles published from 1/Jan/2010 to 31/Aug/2022. Results Bacteria, fungal, TB and schistosomiasis are uncommon causes of haemorrhagic cystitis burdened by high morbidity, especially if not promptly diagnosed. Conclusion Because haemorrhagic cystitis ranges in severity from mild dysuria associated with pelvic discomfort to severe life-threatening haemorrhage, punctual diagnosis, and immediate treatment are essential to avoid further complications.
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Affiliation(s)
- Francesca Ambrosini
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Niccolò Riccardi
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Sara Occhineri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Tommaso Matucci
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Irene Paraboschi
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alfredo Berrettini
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - André Van Der Merwe
- Department of Urology, Faculty of Medicine and Health Sciences, 26697 Stellenbosch University, Cape Town, South Africa
| | - Carlo Terrone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Guglielmo Mantica
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
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Schmitz-Dräger BJ, Skutetzki A, Rieker RJ, Schwab SA, Stöhr R, Bismarck E, Savov O, Ebert T, Benderska-Söder N, Hartmann A. Eosinophilic cystitis mimicking bladder cancer-considerations on the management based upon a case report and a review of the literature. Virchows Arch 2021; 479:523-527. [PMID: 33576854 DOI: 10.1007/s00428-021-03049-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 02/05/2023]
Abstract
The hypereosinophilic syndrome (HES) is a rare disorder characterized by hypereosinophilia and infiltration of various organs with eosinophils. Eosinophilic cystitis (EC), mimicking bladder cancer clinically but also in ultrasound and in radiographic imaging, is one potential manifestation of the HES occurring in adults as well as in children. This case report describes the course of disease in a 57-year-old male presenting with severe gait disorders and symptoms of a low compliance bladder caused by a large retropubic tumor. After extensive urine and serologic examination and histologic confirmation of EC the patient was subjected to medical treatment with cetirizine and prednisolone for 5 weeks. While gait disorders rapidly resolved, micturition normalized only 10 months after initiation of therapy. Based upon this course the authors recommend patience and reluctance concerning radical surgical intervention in EC. Key Points • Eosinophilic cystitis is a rare condition with app. 200 cases reported, so far. • Etiology of eosinophilic cystitis is obscure, but allergies and parasitic infections may trigger the disease. • Genetic alterations (e.g., BRAF mutations) may predispose for the disease • Corticosteroids and antihistamines are the backbone of therapy and may be complemented by antibiotics and non-steroidal anti-inflammatory drugs in case of concomitant (underlying) infections. • As recovery can occur even after a long time, radical surgery should be restricted to highly selected cases.
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Affiliation(s)
- Bernd J Schmitz-Dräger
- St. Theresienkrankenhaus, Nürnberg, Urologie 24, Nuremberg, Germany. .,Department of Urology and Pediatric Urology, Friedrich-Alexander University, Erlangen, Germany.
| | - Andreas Skutetzki
- Department of Trauma Surgery and Orthopedic Surgery, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Ralf J Rieker
- Department of Pathology, St. Theresienkrankenhaus, Nuremberg, Germany.,Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Siegfried A Schwab
- Radiologis, Dr. Meer und Kollegen, Oberasbach-Nuremberg, Zirndorf, Germany
| | - Robert Stöhr
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | | | - Orlin Savov
- St. Theresienkrankenhaus, Nürnberg, Urologie 24, Nuremberg, Germany
| | - Thomas Ebert
- St. Theresienkrankenhaus, Nürnberg, Urologie 24, Nuremberg, Germany
| | | | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
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