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Year : 1999  |  Volume : 15  |  Issue : 2  |  Page : 116-122

Vesical and paravesical inflammatory granulomas of varied aetiology


Dept. of UrologySanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India

Correspondence Address:
K V Sanjeevan
Dept. of UrologySanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow
India
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Source of Support: None, Conflict of Interest: None


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We report five cases of vesical and paravesical granulomas of varied aetiology and discuss their diagnosis and management. Granulomas may occur a few months to several years after surgery. One of our patients had a neglected laminaria tent kept for abortion four years ago that migrated up anterior to the bladder. She had conceived and delivered a full-term normal baby uneventfully one and a half years after the abortion, and eventually presented with haematuria and right groin swelling. An-other patient who presented with a midline supravesical mass gave a histoer of two diagnostic laparoscopies done over a span of two years for infertility, and endometrial curettage for incomplete spontaneous abortion. The third patient had sustained a gunshot injury in the lower abdomen more than a year prior to the development of haematuria. The bullet deep in the left side of pelvis was left unretrieved at the time of initial laparotomy and there was an inflammatory band of encapsulated tissue from the bullet to the bladder wall. The fourth patient presented with a painful lower abdominal mass one year after herniorrhaphy. The fifth patient started having dysuria, abdominal pain and irregular fever two months after a laparoscopic cholecystectomy. Another five months later, she was found having a large paravesical inflammatory mass with intravesical bullous lesions. All these patients were managed surgically. The improtance lies in including granulomas as a differential diagnosis of paravesical mass lesions and thus avoiding judiciously a radical surgery.


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