Department of Urology, Faculty of Medicine, Kyoto Univeersity
Abstract
A 77-year-old woman first noted frequency sense of retention and gross hematuria 2 weeks before she was sent to our department for marked pyuria. Escherichia coli was isolated from her urine. DIP showed normal pyelograms. Vesicoureteral reflux was not identified on voiding cystography. Cystoscopy revealed many yellowish small nodules, 2-3 mm in diameter, over almost the entire mucosa. Transurethral resection of several nodules was performed. Specimens were examined by light microscopy and electron microscopy. The classic Michaelis-Gutmann body was identified. A diagnosis of vesical malacoplakia was made and pyuria improved after treatment with appropriate antibiotics. The Japanese literature is reviewed and several common clinical pictures are summarized. Though malacoplakia of the bladder is considered to be uncommon, 38 cases including our case have been reported and 19 cases have been reported in the last three years. Although there is no definitive treatment for malacoplakia at present, early diagnosis is necessary for the prevention of severe complications
