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
CT

Gross left nephrohydroureter down to the VUJ.

Left sided renal cortical thinning.

Trabeculated urinary bladder.

Undescended left testicle in the inguinal canal.

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.

Fluoroscopy

Usual elongated appearance to the bladder, with trabeculation.

The appearances are those of a pine or Christmas tree.

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!

PlayAdd to Share

Case information

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

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.