Urodynamic evaluation of calcified bilharzial bladders

The functioning of 100 bladders with bilharzial calcification has been urodynamically studied and compared to 30 non-bilharzial healthy males of the same age group. Uroflowmetry, fluid cystometry and pressure flow studies were performed in all bilharzial and control patients. No significant urodynamic differences were found between the bilharzial patients and the control group except that bilharzial patients showed residual urine (mean 100 ml) and delayed first sensation (mean 250 ml). Cystoscopy and multiple deep bladder biopsies were conducted in all bilharzial patients. Histology showed that bladder calcification involves mainly the mucosa and submucosal layers. It was only occasionally that calcified ova were seen in the muscle layers. Since the bladder muscles are largely intact, it is not surprising that the detrusor function is normal even though the bilharzial bladder wall is severely calcified.