title: Neurofibroma invading into urinary bladder presenting with symptoms of obstructed defecation and a large perineal hernia.
abstract: BACKGROUND
  Pelvic floor hernias pose a diagnostic and a treatment challange. Neurofibromatosis is a rare systemic disease, and urinary tract involvement is rare.
  
  
  METHODS
  Here we report a case of a 54-year-old female with multiple neurofibromatosis who presented with features of obstructed defecation and was found to have a large perineal hernia. At surgery, we found an unusual herniation of a large neuropathic bladder and rectum through a perineal defect. She underwent reduction cystoplasty and repair of the pelvic floor using a prolene mesh. Subsequent histopathological examination confirmed a large neurofibroma infiltrating the urinary bladder.
  
  
  CONCLUSIONS
  Neurofibromatosis of the bladder is rare it should be considered as a differential diagnosis in patients presenting with symptoms of obstructed defecation.
authors.forename: Duminda
authors.initials: D
authors.lastname: Subasinghe
authors.forename: Chathuranga Tisara
authors.initials: CT
authors.lastname: Keppetiyagama
authors.forename: Chandu
authors.initials: C
authors.lastname: De Silva
authors.forename: Neville D
authors.initials: ND
authors.lastname: Perera
authors.affiliation: The National Hospital of Sri Lanka, University Surgical Unit, Colombo, Sri Lanka. samarasekera58@yahoo.co.uk.
authors.forename: Dharmabandhu N
authors.initials: DN
authors.lastname: Samarasekera
mesh_terms: D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009456:Neurofibromatosis 1 / Q000150:complications / Q000175:diagnosis*; D059952:Pelvic Floor Disorders / Q000175:diagnosis / Q000209:etiology*; D010502:Perineum / Q000473:pathology*; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis*
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