Unusual Cause of Dysuria: A Large Primitive Retrovesical Hydatid Cyst

Abstract

Hydatidosis is endemic in Morocco. Pulmonary and hepatic localisations are the most frequent. The primary retrovesical location is exceptional. It is considered an “aberrant” or “ectopic” location and represents less than 1% of all cases of hydatid disease. Its diagnosis is sometimes difficult, requiring radiological and serological examinations. The aim of this case report is to present a specific management of a primitive retrovesical hydatid cyst and to compare it with the review of literature. We report an exceptional case of a large primary retrovesical hydatid cyst in a 45-year-old patient with no significant pathological history, of rural origin with a notion of contact with stray dogs. Symptoms are of late onset and represented essentially by voiding disorders associated with episodes of constipation and a feeling of heaviness. Abdominal and pelvic Ultrasound and CT scan identified a rounded, multivesicular retrovesical cystic mass. Because of the existence of intimate adhesions with neighboring organs, we opted for treatment with a partial cysto-pericystectomy. The post-operative follow up was without incident with a good long term evolution. There was no local recurrence and the patient did not complain of any urinary disorder. In order to reduce the incidence of hydatid disease in endemic countries, the best treatment remains primary prevention.