Adenomyomatous polyp causing acute urinary retention in a postmenopausal woman

Abstract

A case of adenomyomatous polyp (AP) causig acute urinary retention in postmenopausal period is presented. A 65-year-old, G8P8 women admitted to our clinic with the complaint of vaginal bleeding and vaginal mass was identified. During preoperative hospitalization she complained about not able to urinate. Serum urea and creatinine levels increased [66 mg/dL (range= 10-45) and 2,49 mg/dL (range= 0. 6-1.3) respectively]. Emergent abdominopelvic tomography showed vaginal mass and overdistended bladder. Mass was removed by vaginal route and abdominal hysterectomy was also performed. Pathologic examination revealed non-malignant AP with massive necrosis. A variety of female reproductive tract diseases can cause urinary obstruction. Treatment choice depends on reproductive expectance of the patient.

Keywords

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Menapoz sonrası bir kadında akut idrar retansiyonuna neden olan adenomatöz polip

Öz

Postmenapozal dönemde akut üriner retansiyona neden olan adenomyomatoz polip (AP) olgusu sunulmuştur. 65 yaşında G8P8 bayan hasta kliniğimize vaginal kanama şikayeti ile başvurdu ve vajende kitle varlığı saptandı. Peroperatif hazırlık için hospitalize edilen hastanın idrar yapamama şikayeti olduğu öğrenildi. Serum üre ve kreatinin değerlerinin yüksek olduğu saptandı [66 mg/dL (normal aralık= 10-45) ve 2,49 mg/dL (normal aralık = 0. 6-1. 3) sırasıyla]. Acil abdominopelvik tomografide vajinal kitle ve distandü mesane izlendi. Kitle vajinal yoldan çıkartıldı ve abdominal histerektomi uygulandı. Patolojik incelemede malign olmayan ve yoğun nekroz alanları içeren AP olduğu saptandı. Kadın genital sistem patolojilerinin bazıları uriner retansiyona neden olabilirler. Tedavi seçimi hastanın fertilite beklentisine bağlıdır.

Anahtar Kelimeler

• Adenomyomatoz polip, akut üriner retansiyon, postmenapoz

References

1. Sugiyama T, Ohta S, Nishida T, Okura N, Tanabe K, Yakush- iji M. Two cases of endometrial adenocarcinoma arising from atypical polypoid adenomyoma. Gynecologic Oncol- ogy 1998;71(1);141-4.
2. Kurman RJ, Mazur MT. Benign diseases of the endometrium. In: Kurman RJ (ed), Blaustein’s pathology of the female genital tract, New York, Springer-Verlag, 1995;367-410.
3. Chhieng DC, Elgert PA, Cangiarella JF, Cohen JM. Cytology of polypoid adenomyomas: A report of two cases. Diagn Cytopathol 2000;22(3):176-80.
4. Breech LL, Rock JA. Leiomyomata uteri and myomectomy. In Rock JA, Jones HW (eds) Te Linde’s Operative Gy- necology, 9th edition, Philadelphia, Lippincott Williams &Wilkins, 2003;774.
5. Derbent A, Turhan NO. Acute urinary retention caused by a large impacted leiomyoma. Arch Gynecol Obstet 2009;280(6):145-7.
6. Glück G, Mitulescu G, Ungureanu D, Stîngu C. Acute uri- nary retention in primary vaginal carcinoma: therapeutic approach. Chirurgia 2007;102(3):349-54.