bladder fistula
Introduction
Introduction to bladder spasm Clinically, patients with bladder spasm are more common, and they can communicate with the skin, intestines, and female reproductive organs. The primary disease is often a disease outside the urinary system. Common causes are: 1 primary intestinal disease - diverticulitis accounted for 50% to 60%, colon cancer 20% to 25%, Crohn's disease 10%, 2 primary gynecological diseases - stressful necrosis caused by dystocia, Progressive cervical cancer, 3 hysterectomy, low caesarean section or tumor after radiotherapy, 4 lesions. Malignant tumor necrosis of the colon, small intestine, vagina and cervix, severe bladder injury leading to the formation of abscess around the bladder, can be ulcerated to the perineum or abdominal cavity. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in women Mode of infection: non-infectious Complications: rectal vaginal fistula
Cause
Bladder spasm
Damage (30%):
Malignant tumor necrosis of the colon, small intestine, vagina and cervix, severe bladder injury leading to the formation of abscess around the bladder, can be ruptured to the perineum or abdominal cavity, may accidentally damage the bladder during vaginal surgery of gynecology and obstetrics, and in addition to bladder cutting and stone removal, Prostate removal can also lead to long-lasting fistula formation.
Primary intestinal disease (40%):
Diverticulitis accounts for 50% to 60%; colon cancer 20% to 25%, Crohn's disease 10%, stress-induced necrosis due to dystocia, advanced cervical cancer, hysterectomy, low caesarean section or tumor radiotherapy.
Prevention
Bladder spasm prevention
1. Properly handle the delivery process, surgical procedures should be standardized.
2. Urinary tract injury is found in the operation, timely correct repair, such as suspected bladder injury, early indwelling catheter, so that the urine flow, bladder emptiness, promote the healing of injured tissue to prevent the formation of paralysis.
Complication
Bladder fistula complications Complications, rectal vaginal fistula
Bladder spasm caused by benign diseases or surgical trauma, the success rate of surgical repair is very high, due to tissue necrosis caused by radiotherapy, the prognosis is often poor, and it is difficult to treat the incision secondary to invasive cancer.
Symptom
Bladder spasm symptoms Common symptoms Bladder vaginal fistula urinary frequency urinary dysfunction urinary dyspnea bladder irritation
(1) Bladder intestinal fistula: symptoms such as bladder irritation, fecal leakage and urethral exhaust may occur, often accompanied by changes in bowel habits caused by primary intestinal diseases.
(2) vaginal fistula: more common, often secondary to obstetric, surgical or radiotherapy injury or cervical cancer, under the cystoscopy through the fistula can be directly connected to the vagina, vaginal angiography can often show ureteral vagina Bladder vaginal and rectal vaginal fistula, another vaginal insertion -foley catheter, after filling the water sac, the appropriate amount of contrast agent can also help diagnose, in some cases, the cancer appears on the edge of the mouth, persky (1980) report 6 cases Children with vesicovaginal fistula are complications of surgical injury.
(3) Bladder attachment: This rare bladder spasm can be diagnosed by vaginal examination and found through the cystoscopy.
Examine
Examination of bladder spasm
Physical examination can be found in the signs of intestinal obstruction, if the inflammatory disease caused by abdominal muscle tension, urine test often prompted infection, barium enema, sigmoidoscopy can show the presence of fistula, usually after barium enema, After taking the urine sample and taking the x-ray examination, it was found that the opaque tincture can confirm the bladder colon fistula. The cystoscopy has important diagnostic value, which can help the positioning of the sacral tract. Intraductal intubation with contrast agents often helps to confirm the diagnosis.
Diagnosis
Diagnosis of bladder spasm
Clinical attention should be paid to the differentiation of vesicovaginal fistula and ureterovaginal fistula.
Oral pyridinium makes the urine orange-yellow. After one hour, put 3 cotton balls in the vagina, then inject methyl methylene blue into the bladder. The patient will check the cotton ball after a short walk. If the outermost cotton ball is wet dyed orange. That is, the ureterospasm is suggested. If the innermost cotton ball is dyed blue, it can be diagnosed as vaginal vagina. If only the outermost cotton ball is blue, the patient may be urinary incontinence.
