Bilateral hydroureteronephrosis with renal failure caused by malacoplakia

Abstract

Malacoplakia is a rare disease. Treatment is not standard and depends on the disease location. Malacoplakia that is isolated to the lower genitourinary tract, after a transurethral resection indicating to obtain a biopsy and debulking, can typically be treated with medication, whereas upper tract disease commonly requires a combination of medical and surgical intervention.

Malakoplakia – perhaps not so benign after all. A case report of bilateral hydroureteronephrosis caused by malakoplakia necessitating a cystectomy

“…One case with renal failure and bilateral HUN was managed with bilateral nephrostomies, unilateral antegrade stenting and contralateral ureteroscopy with balloon dilatation of ureteric strictures followed by retrograde stenting. 2 Three similarly obstructed cases (unilateral and bilateral) in renal failure were managed endoscopically with long-term retrograde stenting but had no other complicating factors such as ureteric involvement/strictures. [3][4][5] There were only two cases found that required open surgery due to malakoplakia obstructing the Vesico-Ureteric junction, with both undergoing ureteroneocystostomy.…”

Malakoplakia Causing Poor Bladder Compliance and Bilateral Hydroureteronephrosis

“…Malakoplakia is usually associated with recurrent UTI, particularly Escherichia coli, Staphylococcus aureus, Proteus, and Klebsiella [4]. The patient was commenced on trimethoprim/sulfamethoxazole 150/100mg daily prophylaxis, which was switched to cephalexin 500mg daily prophylaxis due to poor tolerance.…”