Vesical varices: An uncommon cause of gross hematuria in young men.

INTRODUCTION

and importance: Vesical varices are a rare condition. they are an exceptional cause of hematuria. The most common cause of vesical varices reported in literature is portal hypertension. Usually, varices due to portal hypertension develop in the gastroesophageal region. A multidisciplinary team approach is required, with input from gastroenterologists, interventional radiologists, and urologists.

CASE PRESENTATION: We present a case of A 38 -year- old man presented to our office for 2 episodes of total macroscopic gross hematuria. The detailed general physical examination revealed: a patient in a good condition, without pallor or icterus. Laboratory investigations are normal. Cystoscopy under locoregional anesthesia was performed. It revealed a group of dilated sub mucosal veins, in the trigone. After discussing the case with gastroenterologists, we had presumed that the etiology of vesical varices may be the portal hypertension.

CLINICAL DISCUSSION: Vesical varices are an extremely rare cause of hematuria. The most common cause of vesical varices reported in literature is portal hypertension. The vesical varices may remain asymptomatic for a long period and manifest with hematuria in some cases. In order to organize the management of bleeding vesical varices, a detailed cartography of vesical vascularization have to be performed, including cystoscopy and abdominal contrast tomography (10). No definitive treatment has been established for bleeding vesical varices. In case of gross hematuria, surgical devascularization, laser sclerosis and coagulation are often only of temporary effectiveness.

CONCLUSION

Vesical varices are an extremely rare pathology. Its main etiology is Portal hypertension. The hematuria due to vesical varices could be life threatening. It requires energetic treatment. The goal of the treatment is portal decompression.