Schistosomiasis (urinary tract manifestations)

Radswiki et al.

Bladder schistosomiasis, also known as bilharzia of the bladder, is a major health problem in developing parts of the world predisposing individuals to squamous cell carcinoma.

Schistosomiasis is very common, affecting over 200 million people, with the vast majority (85%) in Africa. It is prevalent in tropical and subtropical areas, especially in rural regions 2,3.

There are five species of the blood fluke (trematode worm) Schistosoma species that cause disease in humans 3:

  • Schistosoma haematobium
  • S. mansoni
  • S. japononicum
  • S. intercalatum
  • S. mekongi

Larvae are released from snails (intermediate host) into water and penetrate human skin (definitive host) exposed to the infected water. These larvae travel to the lungs and liver of the human host, where they reside until they mature.

After maturation, the adult worm pairs travel to the pelvic veins. Eggs are deposited in the bladder wall vessels and incite a granulomatous response that results in polypoid lesions. The eggs may go on to incite a chronic inflammatory response and fibrosis, which is an important predisposing factor for squamous cell carcinoma (SCC).

Imaging findings mirror the pathologic course.

In the acute phase, nodular bladder wall thickening is observed at urography or cross-sectional imaging.

The chronic phase is characterized by a contracted, fibrotic, thick-walled bladder with calcifications. These calcifications are typically curvilinear and represent the large numbers of calcified eggs within the bladder wall. A mass may be secondary to inflammation or complicating carcinoma, typically SCC.

Share article

Article information

rID: 12755
System: Urogenital
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Bladder schistosomiasis
  • Schistosomiasis of the bladder
  • Bilharzia of the urinary tract
  • Bilharzia of the bladder

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Schistosoma haema...
    Case 1
    Drag here to reorder.
  • Drag
    Case 2: with SCC
    Drag here to reorder.
  • Drag
    Case 3
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.