Paroxysmal Hypertension Associated With Urination

Ying Lou, Luyun Fan, Xiaopei Hou, Anna F. Dominiczak, Ji-Guang Wang, Jan A. Staessen, Bader Almustafa, SiewMooi Ching, Alexandre Persu, Michael Bursztyn, Jun Cai*, Huimin Zhang*

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review


We herein reported 2 rare cases of urinary bladder paraganglioma presenting with severe postmicturition syndrome and paroxysmal hypertension, in the absence of hematuria. Biochemical tests of plasma catecholamines after symptoms' onset and determinations of metanephrines in plasma or urine can assist in screening for paragangliomas but can also be falsely negative due to multiple factors such as small tumor size, preanalytical procedures, and concomitant medications. Imaging tests are required to identify the location and size of the tumor, with thorax, abdomen, and pelvis CT scans recommended. Functional imaging examinations including MIBG, octreotide scintigraphy, and positron emission tomography are needed to identify additional lesions and their function via whole-body exploration. Diagnostic accuracy of different functional imaging examinations highly depends on the type and location of tumors and requires further investigation. Genetic tests are valuable for prediction of increased risk of malignancy in affected individuals and their relatives. Surgery after sufficient adrenergic blockage remains the mainstream treatment for localized tumors with generally optimistic outcomes. Longterm follow-up is necessary to monitor tumor recurrence.

Original languageEnglish
Pages (from-to)1068-1074
Number of pages7
Issue number5
Publication statusPublished - Nov 2019



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