International Urology and Nephrology 34: 293–297, 2002. © 2003 Kluwer Academic Publishers. Printed in the Netherlands. 293 Polypoid cystitis unrelated to indwelling catheters A report of eight patients Süleyman Kiliç 1 , Rezzan Erguvan 2 , Deniz ˙ Ipek 1 , Hasan Gökçe 2 , Ali Güne¸ s 1 , N. Engin Aydin 2 & Can Baydinç 1 1 Department of Urology, Inonu University Medical Faculty, Turgut Özal Medical Center, Malatya, Turkey; 2 Department of Pathology, Inonu University Medical Faculty, Turgut Özal Medical Center, Malatya, Turkey Abstract. Since polypoid cystitis (PC) is generally caused by indwelling catheter use, in order to evaluate the patients with PC unrelated to a intravesical catheter, a retrospective analysis of the records of the Pathology Department of Turgut Özal Medical Center was performed and this revealed 8 patients. Mean age of the 2 female and 6 male patients was 48 years (28 to 70). None of the patients had bacterial growth in urine cultures. All cases were diagnosed incidentally by radiologic and cystoscopic examinations in the evaluation of different conditions, such as hematuria, ovarian abscess, bladder carcinoma, erectile dysfunction, neurogenic bladder, benign prostate hyperplasia and unexplained dysuria. At the beginning, all patients were diagnosed mistakenly as bladder carcinoma. The definitive diagnosis was made after histopathologic examinations of transurethrally resected specimens. Patients were followed for 6 months to 2 years after first diagnosis. No recurrence was established during follow-up. The final urologic examinations which were done currently, were normal. In conclusion, PC is a benign lesion and should be considered in the differential diagnosis of transitional cell carcinoma of the bladder. Key words: Bladder, Bullous cystitis, Catheter reaction, Papillary cystitis, Polypoid cystitis Introduction Polypoid cystitis is a reversible, exophytic inflam- matory lesion of the bladder mucosa and charac- terized histologically by normal or mildly hyper- plastic urothelium overlying a congested, chronically inflamed and markedly edematous stroma [15]. The polypoid, papillary and bullous cystitis are essentially identical in their inflammatory reactive patterns. They are different on account of the gross morphologic characteristics of exophytic lesions [13]. Polypoid cystitis is recognized frequently in patients with indwelling catheters and seen mostly on the dome and posterior wall of the bladder which corresponds to the localization of the tip of the catheter. It may be difficult to distinguish it from tran- sitional cell carcinoma macroscopically at cystoscopy because of exophytic nature of the lesion, especially in patients with no history of a catheter. But they can be easily distinguished histologically as an inflam- matory pseudopolyp [15]. There are several reports of PC in patients who are unrelated to an indwelling catheter [1, 4, 7, 12, 14, 16, 17, 18]. In this report, we present the clinical and pathologic features of 8 patients with PC who did not have an indwelling catheter and were confused with carcinoma at initial radiologic and cystoscopic evaluation. Patients and methods The records of Pathology Department of Inonu University Medical Faculty, Turgut Özal Medical Center over eight years were retrospectively reviewed to identify the patients with PC, who did not have a history of recent urinary bladder catheterization. Eight patients covering this condition were encountered. The ages, sexes, symptoms and physical findings, blood and urine analyses, radiographic findings, the locali- zations and appearances of the lesions on cystoscopic examinations were taken into consideration. Seven of the 8 patients were called for re-examination of recur- rence. One of the patients was dead due to cardiac problems 2 years ago. Blood levels of urea, creati-