The less familiar manifestations of schistosomiasis of the urinary tract

One hundred and fifteen patients with schistosomiasis of the urinary tract were studied. Sixty-five percent of the ureters showed striking deformities, including medial deviation, a straight lumbar course, and in the pelvic segment a bowed appearance with medial and cranial displacement at the vesico-ureteric junction. This appearance, which resembles a "cowhorn", is due to fiborsis the bladder trigone. Stasis and dilation of the upper urinary tract were present in the absence of mechanical obstruction. Strictures were rare (7%), and fluoroscopy during excretory urography confirmed that the changes in the upper urinary tract were due to functional derangement of the ureters and not strictures. Four patterns of bladder calcification are described--the familiar linear rim calcification, an amorphous form, uniform opacity and curvilinear forms. The diagnosis can be suggested from the post-micturition bladder film which shows a coarse, shaggy or polypoid mucosal pattern in all stages of the disease.