A 66-year-old man presented with a long history of recurrent attacks of urinary retention and lower urinary tract symptoms. Flexible cystoscopy showed a urethral stricture. Follow-up cystoscopy 7 years later for recurrent symptoms demonstrated unusual extensive mucosal brown to black pigmentation, which proved histopathologically to be a simple bladder melanosis. Follow-up demonstrated complete resolution over a period of 1 year with no specific treatment. In this report, we highlighted a rare bladder abnormality with uncertain natural history.
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