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Case report
Micturition syncope: a rare presentation of bladder paraganglioma
  1. Neethu Sunil V,
  2. Kevin John,
  3. Sultan Nawahirsha and
  4. Ramya Iyyadurai
  1. Internal Medicine, Christian Medical College, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Neethu Sunil V; neethusunilv{at}


A 68-year-old woman presented with episodes of headache, palpitations, sweating and poorly controlled hypertension for the past 6 years. These symptoms were, at times, associated with micturition, and there were few episodes of micturition syncope as well. She had elevated 24-hour urinary normetanephrine and was found to have a paraganglioma arising from the urinary bladder infiltrating the sigmoid colon. She underwent laparotomy with excision of the bladder paraganglioma, following which her symptoms subsided. Paragangliomas are extra-adrenal catecholamine-producing tumours. Bladder paragangliomas need to be considered when evaluating hypertensive patients with headache, palpitations or syncope related to micturition.

  • hypertension
  • urology
  • adrenal disorders

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  • NSV and KJ are joint first authors.

  • NSV and KJ contributed equally.

  • Contributors NSV and KJ conceived, designed and drafted the manuscript. KJ was the resident and SN was the consultant involved in patient care. RI was the senior professor and Head of the Department. KJ, SN and RI reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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