Vulval mycetoma: a rare cause of bladder outlet obstruction.

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Research type: Research Paper

Authors: Fahal, A.H..Sharfy, A.R.A..

Abstract: A case is reported in a 20-year-old woman from Sudan [date not given], who presented with acute urinary retention. Examination revealed a massive mycetoma involving the upper part of the medial aspect of the right thigh, perineum and vulva, with purulent discharge, and a suprapubic catheter was inserted. The mycetoma had started 10 years previously, as a small painless mass in right thigh, and had rapidly increased in size and developed multiple discharging sinuses during pregnancy 18 months before presentation. A local surgical excision had been performed 1 year earlier but the mass had soon recurred. Histopathological examination of vulval specimen showed grains and inflammatory reaction characteristic of Actinomadura pelletieri infection. After urethral dilation a urethral catheter was inserted. Symptoms improved after therapy with streptomycin and rifampicin, although at follow-up 3 months later the patient still required regular urethral dilatation. (7 ref.) .