Neurogenic bladder

Case contributed by Dr Ian Bickle

Presentation

Teenage boy with a history of urogenital problems, including previous surgery, since childhood.

Patient Data

Age: 18
Gender: Male
Modality: CT

Gross left nephrohydroureter down to the VUJ.

Left sided renal cortical thinning.

Trabeculated urinary bladder.

Undescended left testicle in the inguinal canal.

Modality: MRI

Enlarged elongated trabeculated urinary bladder.

Left severe chronic nephrohydroureter.

Undescended left testicle - in the groin.

The urinary catheter is inflated in the posterior urethra.

Modality: Fluoroscopy

Usual elongated appearance to the bladder, with trabeculation.

The appearances are those of a pine or Christmas tree.

Modality: Diagram

Illustrated by Dr Matt Skalski.

Case Discussion

Multi-modality appearances of a neurogenic bladder.   The bladder becomes elongated as opposed to its normal 'ball like' appearance, with a apex in the cranial direction.  In addition the bladder wall becomes trabeculated - the combined appearances give the distinct Aunt Minnie appearance of a Christmas tree bladder.

In this case a number of other interesting additional findings are present:

- Left sided undescended testicle

- Chronic right hydronephrosis

- Iatrogenic abnormality of a urethral catheter ballon inflated in the posterior urethra - may possible by the patient's neurogenic status. Inflated a ballon there beyond 2-3mls in a normal patient and you will know it!

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Case Information

rID: 29058
Case created: 30th Apr 2014
Last edited: 4th Apr 2017
System: Urogenital
Inclusion in quiz mode: Included

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