Urinary Retention Due to Benign Tumor of the Bladder Neck in a Woman; A Rare Case of Papillary Cystitis

Abstract

Urinary retention (UR) is not common in women. There are numerous causes now recognized in women, broadly categorized as infective, pharmacological, neurological, anatomical, myopathic and functional. As opposed to the male, obstructive UR is unusual in women. A 56-year-old woman presented with urinary retention. She reported difficulty in urination for more than 15 days. She had no history of urinary tract infection, bladder surgery and catheterization. Her physical examination revealed a soft tissue mass obstructing the external orifice of the urethra. After its partial removal the patient regained her ability to urinate. The patient underwent urological investigation. Ultrasound examination of the urinary system was normal. Cystoscopic examination revealed a papillary lesion with broad base floating along the bladder neck. The patient underwent transurethral resection of the bladder tumor. Pathological examination diagnosed papillary cystitis. She was scheduled for a regular follow-up with urine cytology, ultrasound and cystoscopy. One year after diagnosis the patient remains free of symptoms and no recurrence was observed. Papillary and polypoid cystitis are benign lesions, however under certain circumstances they should be considered in the differential diagnosis of transitional cell carcinoma of the bladder. Lack of the prominent inflammation and edema that characterizes both papillary and polypoid cystitis, and absence of a history of recent bladder catheterization and presence of vesical fistula may facilitate the decision to biopsy the lesion. To our knowledge, this is the first case of papillary cystitis presenting with urinary retention in a woman to be reported in the literature.