434
edits
Changes
no edit summary
This 30-year-old black male was born with a meningocele which was repaired in childhood. Despite repair of the meningocele, this patient continued to have a neurogenic bladder.
Six months previous to this admission, the patient passed a single renal calculus but intravenous pyelograph pyelogram (IVP) showed left nephrolithiasis (a 1 cm stone in the lower lobe). For 6 months the patient had to be catheterized each day for 6 hours. However, he continued to complain of hesitancy and urgency and suffered occasional urinary tract infections.
On this admission, a culture of the patient's urine specimen grew Gram-negative bacilli (Proteus species). Cystoscopy showed heavy trabeculation of the bladder with early diverticula and the left ureteral orifice showed squamous metaplasia. The lower pole of the left kidney was removed surgically, following which the patient recovered and was discharged on antibiotics.
