Retrovesical hydatid cyst presenting with urinary retention and left kidney atrophy

The authors have reported a rare case of retrovesical hydatid cyst which had caused chronic obstructive changes in the left kidney. On diagnostic imaging, the differentials of a pelvic/retrovesical cyst in men are not many and include duplication cysts, mesenteric cysts, lymphocele in patients who have undergone radical surgeries,[1] and hydatid cysts. However, the reporting radiologist has to consider hydatid cyst as a likely possibility in an endemic area and alert the treating physician because of the management implications. There are several case series published recently.[2,3,4] Angulo et al. and Horchani[3,4] also highlight the difficulties encountered in the surgical management of the complicated hydatid cysts in which a proportion of cases had adherence to the urinary bladder and total or partial cystectomy had to be done. Postoperative death was also reported by Horchani. There is a lot of improvement in the surgical techniques of hydatid cyst, such as the Palanivelu hydatid system (PHS), which is a special instrument[5] with a trocar and two channels, and can be used to aspirate the cyst without spilling the contents and for the treatment of pelvic hydatid cysts as well. This case report has teaching points to both radiologists as well as surgeons.