[Primary amyloidosis localized in the bladder]. / Amiloidosis primaria localizada de vejiga urinaria.

OBJECTIVE: We report a case of localized amyloidosis of the urinary bladder in an 80-year-old female whose main presenting symptom was massive hematuria. METHODS: Cystoscopic examination revealed a tumor on the trigone and bladder neck. A transurethral resection of the tumor was performed and the fragments were processed for histopathological study with hematoxylin-eosin and Congo red staining and ultrastructural study. RESULTS: The histopathological analyses disclosed large eosinophilic deposits in the submucosa with birefringence under polarized light in Congo red staining. Electron microscopy revealed a meshwork of filaments typical of amyloid. The patient had no symptoms or signs of systemic disease and remains symptom-free four years later. CONCLUSIONS: Primary localized amyloidosis of the urinary bladder is a rare condition that can be successfully treated surgically and has an excellent prognosis.

[A new pathology: unstable urinary bladder (author's transl)]. / Una nueva patología: la vejiga inestable.

Thirty-five cases of incontinence of urine due to hyperactivity of the detrusor as a result of unstable urinary bladder were found among 100 patients with incontinence. The cause of the hyperactivity was established after a thorough urological and neurological screening with intravenous urography, seriated mictional cystoureterography, cystoscopy, and urine culture. The diagnosis was considered definite if uninhibited contractions of the detrusor were detected by electrocystomanometry. The primary clinical symptom was an imperious urge to mi-turate, with or without leakage of urine. Diurnal and nocturnal frequency was exacerbated in cold weather and in contact with water. There were some instances of a history of late enuresis and association with cystoceles. Anticholinergics (propantheline bromide) are the treatment of choice. Surgery should be indicated only after all medical attempts have failed.