title: Invasive fungal bezoar requiring partial cystectomy.
abstract: A 67-year-old man developed dysuria and position-dependent obstructive voiding symptoms after undergoing holmium laser ablation of the prostate (HOLAP) for benign prostatic hypertrophy. A large fungal (candidal) ball adherent to the bladder wall was removed by loop excision, but the bezoar recurred in 2 weeks despite systemic fluconazole and intravesical amphotericin B. A second attempt at endoscopic removal with ultrasonic lithotripsy, endoscopic graspers, and fulguration was also unsuccessful. The patient underwent open partial cystectomy to remove his invasive fungal bezoar. Convalescence was unremarkable. Urinalysis, culture, and follow-up cystoscopy after partial cystectomy demonstrated successful definitive treatment of the fungal ball.
authors: James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21224, USA.
authors: Debasish
authors: D
authors: Sundi
authors: Kenneth
authors: K
authors: Tseng
authors: Jeffrey K
authors: JK
authors: Mullins
authors: Kieren A
authors: KA
authors: Marr
authors: Matthew Eric
authors: ME
authors: Hyndman
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001630:Bezoars / Q000188:drug therapy / Q000601:surgery*; D002177:Candidiasis / Q000188:drug therapy / Q000601:surgery*; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000379:methods*; D003558:Cystoscopy; D053159:Dysuria / Q000209:etiology; D004564:Electrocoagulation; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State; D008096:Lithotripsy; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000601:surgery; D012008:Recurrence; D001743:Urinary Bladder / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole