Non-Neurogenic ‘Christmas Tree’ Urinary Bladder in A 30-Year-Old Man with Urethral Stricture: A Case Report

Abstract

condition the urinary bladder appears elongated and pointed with a thickened, trabeculated wall likened to a Christmas tree. It is most commonly the result of neurogenic bladder from detrusor hyperreflexia which most commonly occurs after spinal trauma. Christmas tree bladder also may rarely be seen in cases of bladder neck obstruction of non- neurogenic cause. A 30-year-old male presented with two weeks history of leakage of urine par the perineum. There was prior history of urethral discharge, poor urinary stream, urine dribbling and dysuria. No history of genital trauma, urethral instrumentation or catheterization in past. Attempt at passage of urethral catheter failed. He subsequently had open supra pubic cystostomy. Ultrasonography shows multiple internal echoes in the urine with thickened irregular bladder wall. The upper urinary tract was normal. Combine RUG and VCUG demonstrate short segments strictures at the bulbar and membranous urethra. A track of contrast column was noted from the region of the bulbar stricture to the exterior consistent with urethro-cutaneous fistula. The urinary bladder appears large, elongated superiorly with irregular outline resembling ‘Christmas tree’ configuration.