[Vesical malacoplakia accompanied with bilateral hydronephrosis: a case report]

A 63-year-old female with a complaint of pollakisuria was referred to our clinic for the treatment of bilateral hydronephrosis. Ultrasonography, computerized tomography (CT) scan and magnetic resonance imaging (MRI) revealed bilateral hydronephrosis due to stenosis of the vesicoureteral junction, which was caused by a nodular mass on the posterior wall of the bladder. Cystoscopy revealed a yellowish-white mass on the trigone. Bilateral percutaneous nephrostomy for the treatment of chronic renal failure due to bilateral hydronephrosis and transurethral resection of bladder tumor were performed. Histological findings indicated a chronic granuloma with Michaelis-Gutmann body and the tumor was diagnosed as vesical malacoplakia. Oral administration of trimethoprim sulfamethoxazole, bethanecol chloride and vitamin C was done for the conservative therapy of malacoplakia. However, stenosis of the vesicoureteral junction remained. Then, bilateral vesicoureteroneostomy was performed and there was no obvious recurrence of malacoplakia 20 months postoperatively.