Peritoneal mouse presenting with symptoms of overactive blad
Peritoneal loose bodies called ‘peritoneal mice' are rare entities that can grow to large sizes and produce lower urinary tract symptoms due to a mass effect. Published in the Indian Journal of Urology, the authors describe a case that was managed with laparoscopic removal of the mass with complete resolution of symptoms.

A 50-year-old male presented with dull-aching pain in the lower abdomen with increased frequency and urgency of urine. He had normal prostate on digital rectal examination and ultrasound. Ultrasound KUB showed a mass measuring 5 cm × 4 cm behind the bladder. MRI abdomen revealed a mass of 5 cm × 4 cm in the rectovesical pouch. The mass was well circumscribed and nonenhancing. It showed low intensity on both T1- and T2-weighted (T1W and T2W) images.

MRI signal was similar to that of the muscle with central high-intensity area on T1W images. Laparoscopy revealed a free-floating egg-shaped, glistening white mass in the rectovesical pouch. The mass was not attached to any pelvic structure and it was removed in an endocatch bag. On sectioning, it had a classic ‘boiled-egg' appearance. The white part was smooth and soft in consistency, while the central yellow part was slightly firm.

The surfaces were smooth. Histopathology revealed laminated strands of a fibrinoid substance with a large amount of proteinaceous material in the peripheral white part and saponified fat with calcification in the central yellow part. His urinary symptoms and pain subsided after removal of the mass.

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