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Fungal infections of the perivesical space
1Division of Urology, Maimonides Medical Center, Brooklyn, New York.
Abstract:
We describe 3 patients with fungal infection in the perivesical space who manifested lower abdominal pain and urinary tract symptomatology. Imaging studies demonstrated perivesical abnormalities. Urine culture was positive for fungus in only 1 patients. Management required surgical exploration, drainage, débridement of necrotic tissue and in 1 patient partial bladder resection. Systemic antifungal therapy was administered postoperatively. All patients had a successful outcome.
Insights
Fungal perivesical infections are rare but serious, causing abdominal pain and urinary symptoms. Successful management involves surgery, drainage, debridement, and antifungal therapy.
Area of Science:
- Urology
- Mycology
- Surgical Pathology
Background:
- Perivesical fungal infections are uncommon but can lead to significant morbidity.
- Early diagnosis and intervention are crucial for favorable outcomes.
Observation:
- Three patients presented with lower abdominal pain and urinary tract symptoms suggestive of perivesical pathology.
- Imaging revealed abnormalities in the perivesical space.
- Fungal presence in urine culture was confirmed in only one patient.
Findings:
- Surgical intervention, including drainage and debridement of necrotic tissue, was necessary for all patients.
- One patient required a partial bladder resection.
- Postoperative systemic antifungal therapy was administered.
Implications:
- Aggressive surgical management combined with antifungal therapy can lead to successful outcomes in perivesical fungal infections.
- Diagnostic challenges exist, as urine cultures may not always detect the fungus.
- Further research into non-invasive diagnostic methods is warranted.