[A case of proliferative chronic cystitis, progressing to obstructive nephropathy, treated by total cystectomy and...

A 52 year-old man, being pointed out as with microscopic hematuria and suspected of carcinoma of the urinary bladder at another institution, visited this hospital for further examination. DIP demonstrated an irregular right lateral wall of the urinary bladder. CT of the pelvic cavity revealed a protrusive mass lesion inside the urinary bladder. Cystoscopy proved a circular, edematous and irregular mass lesion around the urinary bladder neck. The pathological examination of TUR specimens showed a proliferative chronic cystitis. However, after about half a year, there was a recurrence of mass lesions in the urinary bladder. Moreover, right non-functional kidney and left hydronephrosis were observed. For preserving renal function, total cystoprostatectomy was performed. Nerve sparing technique for sexual function, and total bladder replacement using a detubularized sigmoid colon to obviate the need for a stoma were adopted. Postoperative course was uneventful and the function of both kidneys was recovered. Normal urination from the urethra and sexual function are both preserved. Pathological examination of the cystectomized specimen confirmed only proliferative cystitis with extensive deep ulceration and thick connective tissues. A rare case in which obstructive nephropathy was caused by proliferative cystitis is reported and discussed.