1. Multipathogenetic Origin of a Pelvic Mass
Marco Oderda, Paolo Mondino, Andrea Zitella, Dario Vigna, Chiara Fiorito, Donatella Pacchioni, Alessandro Tizzani, Paolo Gontero 
European Urology 
Volume 55, Issue 5, Pages (May 2009)
DOI: /j.eururo
Copyright © 2009 European Association of Urology Terms and Conditions

2. Fig. 1
Abdominal computed tomography picture showing a large bladder stone and a supravesical cystic mass.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions

3. Fig. 2
Intraoperative image showing the voluminous bladder cancer after removal of the stone. The supravesical mass has been removed. The thick bladder wall shows a large laceration that occurred during the surgical manoeuvres.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions

4. Fig. 3
Pathologic sample of the supravesical cystic mass: fibromuscular wall with sclerosis (deeper part in upper inset) and superficial ulceration (lower inset) at low power magnification. This pattern is consistent with a urachal cyst.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions

5. Fig. 4
Pathologic sample of a large papillary lesion surrounding the bladder stone and occupying most of the bladder surface: high-grade transitional cell carcinoma.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions

6. Fig. 5
Voiding phase of the videourodynamic investigation: bilateral grade 4 vesicoureteral reflux. The bladder neck is widely opened.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions

7. Fig. 6
Videourodynamic results show no signs of detrusor overactivity, a slight reduction of the vesical compliance, and a normal voiding phase (maximal flow rate: 43ml/s). The vesical catheter is ejected immediately after the onset of micturition. The morphology of the abdominal pressure curve shows a slight increase consistent with abdominal strain. During the voiding phase, the bladder neck relaxes normally without evidence of urethral stricture. Overall, urodynamic parameters rule out a bladder outlet obstruction.
European Urology  , DOI: ( /j.eururo )
Copyright © 2009 European Association of Urology Terms and Conditions