1. Potpourri
Friday, September 17, 2004

2. Abnormal Pelvic Calcifications
Phleboliths
Nephro/ureterolithiasis
oxalate>cystine>urate
Bladder wall calcifications
Bladder stones
Tumors (GU, Gyn, GI)

3. Schistosomiasis Trematode (fluke) Snails as intermediate host
female produces 300 eggs/d
200 million worldwide infected
Africa, S. America, Asia
worm lifespan 5-10 yrs
Set up in vesical venous plexus
haematobium
mesenteric plexus
japonicum
mansoni
mekongi
intercalatum

4. Schistosomiasis Turn into cercaria in snail liver S. haematobium
penetrate skin/membranes and via lymph to vesicular plexus.
dysuria, haematuria, anaemia, or hydronephrosis.
Carcinoma of the bladder
S. haematobium
Bilharzia
East Africa, Asia, Mediterranean, Arabia
Ova deposited by female fluke in bladder wall, passed
Miracidia develop in ovum in water

5. Urinary Schistosomiasis
Diagnosis
urine for eggs (midday)
serology
Praziquantel 20mg/kg, 2 doses in 1 day

6. Figure 68-22 Bilharzia. Bladder calcification.

7. Schistosomiasis
calcification of the bladder wall in a band 1–3 mm wide
areas of calcification are located in submucosa
filling defects due to granulomas from allergic reaction.
Strictures more commonly involve the bulbar urethra and are secondary to the fistulous tract formation
ureteritis cystica
parallel lines seen in ureters

8. Figure 70-16 (A) Irregular calcification of a bladder tumour (arrow)
Figure (A) Irregular calcification of a bladder tumour (arrow). (B) After contrast medium the whole of the bladder appears abnormal, a finding subsequently confirmed at cystoscopy.

9. Figure 72-10 Urinary schistosomiasis
Figure Urinary schistosomiasis. Calcification within the bladder wall (open arrows) and ureter (solid arrows) characteristic of schistosomiasis infection

10. Urinary Tuberculosis descending infection
renal, bladder, and prostatic involvement
early stages bladder trabeculation
later stages thick-walled w/small capacity
may calcify
Anterior urethral strictures
periurethral and periprostatic abscesses
perineal and recto- urethral fistulas