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Unusual Findings on Cystoscopy in a Patient With Detrusor Overactivity

Nosti, Patrick A. MD; Sokol, Andrew I. MD

Female Pelvic Medicine & Reconstructive Surgery: May/June 2012 - Volume 18 - Issue 3 - p 186–187
doi: 10.1097/SPV.0b013e318254f0c6
Case Reports

Background: Chronic lithium ingestion has been shown to cause polyuria and polydipsia in 20% to 40% of patients, secondary to diabetes insipidus. However, it has not been reported to cause lithium deposition in the bladder.

Case: A 77-year-old woman presented to our clinic with complaints of urinary incontinence, urinary urgency, and nocturnal enuresis for the past 3 to 4 years. She denied polydipsia. Her medical history was significant for bipolar disorder for which she had been on lithium therapy for more than 10 years. Metallic deposition was noted in the suburothelium of a urethral biopsy by gross inspection.

Conclusion: Suburothelial deposition of metal may act as a bladder irritant and account for this patient’s overactive bladder symptoms.

Suburothelial deposition of metal may act as a bladder irritant and account for this patient’s overactive bladder symptoms.

Section of Female Pelvic Medicine and Reconstructive Surgery, Department of Women and Infants’ Services, Washington Hospital Center, Georgetown University School of Medicine, Washington, DC.

Reprints: Patrick A. Nosti, MD, FPMRS, Section of Female Pelvic Medicine and Reconstructive Surgery, Department of Women and Infants’ Services, Washington Hospital Center, Georgetown University, 106 Irving St. NW, Suite 405 South, Washington, DC 20009. E-mail: patrick.nosti@gmail.com.

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins