Patients with inactive disease in endemic areas tend to be adults in the third decade or older.
Features:
(1) viable eggs disappear from tissue and urine, and any residual eggs become calcified
(2) urinary excretion of calcified eggs is rare unless a urothelial disorder occurs such as schistosomal ulceration or onset of a urothelial neoplasm
(3) there is an absence of a vigorous granulomatous host response, so inflammatory polyps are very rare
(4) schistomal ulceration is common
(5) sandy patches are present and may cause obstructive uropathy
(6) high egg burdens (> 20,000 per gram tissue) may be detected on plain X-rays
Diagnosis requires demonstration of calcified eggs in biopsy material by:
(1) histologic section
(2) squash preparation
(3) digestion in potassium hydroxide for 18 hours at 56°C
Management:
(1) chemotherapy is not indicated
(2) surgical repair of obstructive uropathy
