Malakoplakia of the urinary bladder: A review of the literature
https://doi.org/10.4081/aiua.2022.3.350
Accepted: June 23, 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objective: The aim of the study is to make a review of the literature about bladder malakoplakia.
Material and Methods: We searched articles on the PUBMED web-literature database with the following keywords: “vesical malakoplakia” and “bladder malakoplakia”. In the literature we found 254 articles. At final we have excluded 219 articles, including in our study only 35 articles.
Results: The overall average age found was 50.85 years. The average age of men was 43.22 years, while that of women was 53.37 years. 75% of the patient cases were women and 25% were men. Regarding comorbidities, in 5.55% of the cases were missing whereas 47.22% of the patients suffered from recurrent urinary tract infection (UTI) and 19.44% from immune system disorders. Urine culture was positive in 69.44% with E.coli being isolated in 92% of cases. Hydroureteronephrosis was present in 44.44% of the cases: left in 6.25% of cases, right in 18.75% and bilateral in 75%. The mean serum creatinine of patients with hydroureteronephrosis was 5.11 (1-21) mg/dl. The most frequent site of the lesion was the vesicoureteral junction (VUJ) (42.31%), followed by the trigone (38.46%). 30.56% of patients were treated with antibiotic and surgery (transurethral resection of bladder, partial or radical cystectomy), less frequent options were antibiotics alone and surgery alone. The recurrence rate was 15%.
Conclusions: Malakoplakia is a disorder usually related to other affections, like UTI and immunodepression, and it seem to be caused by an abnormal macrophage function. In almost half of the described cases of isolated bladder malakoplakia, hydroureteronephrosis and renal failure were present.Treatment is not standardized, but both medical and surgical therapies are effective to avoid recurrence.
Stamatiou K, Chelioti E, Tsavari A, et al. Renal failure caused by malakoplakia lesions of the urinary bladder. Nephro Urol Mon. 2014; 6:e18522. DOI: https://doi.org/10.5812/numonthly.18522
Sirithanaphol W, Sangkhamanon S, Netwijitpan S, Foocharoen C. Bladder malakoplakia in systemic sclerosis patient: a case report and review literature. J Endourol Case Reports. 2018; 4.1:91-93. DOI: https://doi.org/10.1089/cren.2018.0038
Ristic-Petrovi A, Stojnev S, Jankovic-Velickovic L, Marjanovic G. Malakoplakia mimics urinary bladder cancer: A case report. Vojnosanit Pregl. 2013; 70:606-8. DOI: https://doi.org/10.2298/VSP1306606R
Gao P, Hu Z, Du D. Malakoplakia of the bladder near the ureteral orifice: a case report, J Intern Med Res. 2021; 49:1-5. DOI: https://doi.org/10.1177/03000605211050799
Hina S, Hasan A, Iqbal N, et al. Malakoplakia of the urinary bladder and unilateral ureter. J Coll Physicians Surg Pak. 2019; 29:582-584. DOI: https://doi.org/10.29271/jcpsp.2019.06.582
Rabani S, Rabani S, Bladder Malakoplakia simulating neoplasm in a young girl: report of a case and review of literature. Urol J. 2019; 16:614-615.
Cooper KL, Badalato GM, Rutman MP. Infection of the urinary tract. In: Elsevier (Ed), Campbell-Waslsh-Wein Urology, 12th ed, 2021; 1129.
Shah A, Chandran H. Malakoplakia of bladder in childhood, Pediatr Surg Int. 2005; 21:113-115. DOI: https://doi.org/10.1007/s00383-004-1351-z
Minor L, Lindgren BW. Malacoplakia of the bladder in a 16-yearold girl. J Urol. 2003; 170:568-9. DOI: https://doi.org/10.1097/01.ju.0000071475.79104.98
Callea F, Van Damme B, Desmet VJ. Alpha-1-antitrypsin in malakoplakia. Virchows Arch A Pathol Anat Histol. 1982; 395:1-9. DOI: https://doi.org/10.1007/BF00443481
Patnayak R, Reddy MK, Subramanian S, et al. An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature. Cases J. 2009; 2:7527. DOI: https://doi.org/10.1186/1757-1627-2-7527
Berney DM, Thompson I, Baithun SI. Alkaline encrusted cystitis associated with malakoplakia. Histopathology. 1996; 28:253-256. DOI: https://doi.org/10.1046/j.1365-2559.1996.d01-426.x
Stanton MJ, Lynch JH, Maxted WC, Chun BK. Malacoplakia of the bladder: a case report of resolution with bethanechol, trimethoprim-sulfamethoxazole and ascorbic acid. J Urol. 1983; 130:1174-5. DOI: https://doi.org/10.1016/S0022-5347(17)51742-5
Pozo Mengual B, Burgos Revilla FJ, Briones Mardones G, et al. Malacoplaquia vesical con afectación ganglionar y curso agresivo [Bladder malacoplakia with lymphatic involvement and an aggressive course]. Actas Urol Esp. 2003; 27:159-63. DOI: https://doi.org/10.1016/S0210-4806(03)72896-4
Parkin CJ, Acland G, Sulaiman B, et al. Malakoplakia, a malignant mimic. Bladder. 2020; 7:e44. DOI: https://doi.org/10.14440/bladder.2020.818
Nabeshima A, Yamada S, Xin G, et al. A case of malakoplakia of the urinary bladder]. J UOEH. 2012; 34:265-70. DOI: https://doi.org/10.7888/juoeh.34.265
Baumgartner BR, Alagappian R. Malakoplakia of the ureter and bladder. Urol Radiol. 1990; 12:157-159. DOI: https://doi.org/10.1007/BF02923997
Mukha RP, Kumar S, Ramani MK, Kekre NS. Isolated malacoplakia of the bladder: a rare case report and review of literature, Int Urol Nephrol. 2010; 42:349-350. DOI: https://doi.org/10.1007/s11255-009-9624-z
Jordaan HF, Heyns CF, Allen FJ, Schneider J. Immunosuppressive therapy for pemphigus vulgaris complicated by malakoplakia of the bladder. Clin Exp Dermatol. 1990; 15:442-445. DOI: https://doi.org/10.1111/j.1365-2230.1990.tb02140.x
Sulman A, Goldman H, Malacoplakia presenting as a large bladder mass. Urology. 2002; 60:163. DOI: https://doi.org/10.1016/S0090-4295(02)01662-X
Billis A, Bladder malacoplakia in a patient on chronic hemodialysis waiting for kidney transplantation. Nephron. 1994; 67:127-128. DOI: https://doi.org/10.1159/000187906
Nukui M, Nakagawa Y, Uchida M. Vesical malacoplakia accompanied with bilateral hydronephrosis: a case report. Hinyokika Kiyo. 1997; 43:49-52.
Batchelor JS, Philp NH, Ramsden KL, Scott KWM.Primary lymphoma of the bladder arising from an area of malakoplakia. Br J Urol. 1991; 68:550-1. DOI: https://doi.org/10.1111/j.1464-410X.1991.tb15405.x
Bylund J, Pais JM Jr. A case of acute renal failure caused by bilateral, multifocal malacoplakia lesions of the bladder and ureters. Nat Clin Pract Urol. 2008; 5:516-9. DOI: https://doi.org/10.1038/ncpuro1173
Copyright (c) 2022 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
