Pilimiction

Per urethral hair growth or passage of hair in the urine is a rare urological problem. It is pathognomonic sign of urinary bladder dermoid. Primary bladder dermoid is very rare problem. It could be managed endoscopically when it is limited to detrusor muscle. Secondary dermoid in the urinary bladder is not uncommon among the female specially during their reproductive life. It is mostly ovarian origin. Ovarian dermoid may grow and invade the urinary bladder wall to discharge its content in the urine. Cystoscopic evaluation followed by laparotomy and excision of ovarian dermoid along its extension to the urinary bladder is a rational approach. However if expertise is available it may be managed laparoscopically. Our patient has benign indolent coarse of pilimiction for last 9 years. Except US scans we did not do MRI or CT scan for financial constrain. Keeping an open mind we did cyst evaluation. Attempt of endoscopic resection seems that the dermoid has invaded bladder wall from out side. We did laparotomy in the same sitting. Lt. ovary was almost buried between the leaf of broad ligament and contain a dermoid cyst invading bladder wall to discharge its contents. So we confirm our diagnosis as secondary bladder dermoids as a cause of pilimiction & excise the whole specimen keeping its safety margin. Histopathologically it appears benign mature cystic teratoma.