Leukoplakia
Introduction
Introduction to bladder leukoplakia Bladder leukoplakia is a rare intravesical lesion with a good age of 40 years old and more common in women. The disease manifests as white patches of the bladder mucosa, usually located in the bladder triangle and neck, occasionally invading the entire bladder mucosa. The main symptoms are frequent urination, urgency, dysuria, and difficulty in distinguishing from chronic cystitis. It is believed that bladder leukoplakia is a response to toxic stimuli in normal urothelium, precancerous disease or predictive of malignant lesions in other areas of the bladder. Therefore, attention should be paid to the diagnosis, monitoring and treatment of the disease. Long-term indwelling catheter can cause this disease. basic knowledge Sickness ratio: 0.0001% Susceptible people: good age is about 40 years old, more common in women Mode of infection: non-infectious Complications: cystitis
Cause
Causes of bladder leukoplakia
The etiology of this disease is still unclear, chronic cystitis, bladder stones, long-term indwelling catheter, schistosomiasis bladder patients are prone to bladder leukoplakia, may be caused by long-term chronic inflammation stimulation caused by squamous metaplasia.
Chronic cystitis (30%):
Chronic cystitis is a common urinary tract infection, accounting for about 50% to 70% of the total number of urinary tract infections. Caused by bacterial infection. Most of the pathogenic bacteria are Escherichia coli.
Bladder stones (30%):
Bladder stones are stones formed in the bladder that can be divided into primary bladder stones and secondary bladder stones. The former refers to the stones formed in the bladder, mostly caused by malnutrition, and often occurs in children. With the continuous development of China's economy, children's bladder stones have shown a downward trend, while the latter refers to the upper urinary tract or secondary. Bladder stones formed by lower urinary tract obstruction, infection, bladder foreign body or neurogenic bladder. In economically developed areas, bladder stones mainly occur in older men, and often suffer from benign prostatic hyperplasia or urethral stricture in poor areas. , more common in children, women are rare.
Indwelling catheter (30%):
Long-term indwelling catheter can cause this disease.
Pathogenesis
There are single or multiple scattered leukoplakia in the bladder mucosa, ranging in size from 0.2cm in diameter to invading the entire bladder wall. The new lesion is soft and thin, blue-gray or gray-white, the old lesion is thick, milky white, and the plaque is irregular. The edge is slightly raised, the surface is bloodless, and the surface of the hyperplastic epithelium is often covered with a thick layer of keratin. The metastatic cells are transformed into squamous cells, which reduce the sliding function between cells, thus hindering the normal expansion and contraction of the bladder, and the submucosa. There are a large number of inflammatory cell infiltration, vasodilatation and hyperemia, muscle hyperplasia, edema around the lesion, and congestion.
Prevention
Bladder plaque prevention
1. Carry out psychological care to help the patient relieve the mentality of nervousness, fear, disappointment, etc., and guide them to forget the disease, feel comfortable, and better cooperate with various treatments.
2, to maintain the perineal area, especially the cleanliness of the urethra, to prevent infection.
3, the cause of bladder leukoplakia is still unclear, to understand the risk factors of bladder leukoplakia, the development of appropriate prevention and treatment strategies can reduce the risk of bladder leukoplakia, we are currently facing the focus of bladder plaque prevention and treatment work, should first focus on and improve those Factors that are closely related to our lives, such as smoking cessation, proper diet, regular exercise, and weight loss. Appropriate exercise, enhance physical fitness and improve your disease resistance. Anyone who follows these simple and reasonable lifestyle knowledge can reduce the chance of suffering from bladder leukoplakia.
Complication
Bladder leukoplakia complications Complications cystitis
The disease can be combined with cystitis glandularis.
Symptom
Symptoms of bladder leukoplakia common symptoms urinary frequency urgency urgency fever blood pee
More common in women, no obvious incentives for frequent urination, urgency and urinary incontinence, accompanied by urination discomfort, no or less hematuria, fever and low back pain during the course of the disease.
Because clinical manifestations and chronic cystitis are difficult to distinguish, for patients with repeated urinary tract irritation, anti-inflammatory treatment is not effective, cystoscopy, cystoscopy + biopsy is the only diagnosis
Examine
Examination of bladder leukoplakia
1. Urine examination: Except for those with hematuria, most patients have negative urine examination and urine culture.
2, intravenous urography: more normal examination.
3, cystoscopy: visible in the bladder triangle area, the two side walls have irregular size, clear border, slightly higher than the normal mucosa, gray-white or yellowish, no blood vessels, visible keratinous debris floating.
4, pathological examination: pathological examination confirmed by squamous metaplasia after biopsy, significant keratinization, acanthosis retraction, cell atypical increase
Diagnosis
Diagnosis and diagnosis of bladder leukoplakia
1. Urine examination: Except for those with hematuria, most patients have negative urine examination and urine culture.
2, intravenous urography: more normal examination.
3, cystoscopy: visible in the bladder triangle area, the two side walls have irregular size, clear border, slightly higher than the normal mucosa, gray-white or yellowish, no blood vessels, visible keratinous debris floating.
4, pathological examination: pathological examination confirmed by squamous metaplasia after biopsy, significant keratinization, acanthosis retraction, atypical growth of cells.
