bladder diverticulum
Introduction
Introduction to the bladder diverticulum The bladder diverticulum is congenital and secondary, and the congenital bladder diverticulum wall contains muscle fibers. Acquired multiple secondary to urinary tract obstruction. Patients with bladder diverticulum die before the age of 10 and between 50 and 60 years old. Congenital bladder wall muscle layer localized weak point bulging, the diverticulum is mostly single, the diverticulum wall contains the full layer of the bladder, more common in children, lower urinary tract without obstruction. The bladder wall secondary to the lower urinary tract obstruction self-divided between the detrusor muscle bundles to form a diverticulum, often multiple, mucosal trabeculae in the diverticulum wall (such diverticulum does not contain layers of the bladder wall, Therefore, it is also called pseudo-type diverticulum), more common in adult males, and there is detrusor hyperplasia. basic knowledge The proportion of illness: 0.005%--0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: bladder stones
Cause
Bladder diverticulum
Congenital lesions (30%):
Congenital lesions such as urethral stricture, posterior urethral valve, bladder neck contracture, obstruction promote the formation and development of diverticulum, which is the main factor in the diverticulum. Most patients with bladder neck obstruction do not have diverticulum in the clinic, but there is no obstruction in some diverticulum cases. Exist, so the formation of the bladder diverticulum is also associated with the congenital alignment of bladder muscle fibers.
Prevention
Bladder diverticulosis prevention
Early detection, early diagnosis, and early treatment are important for preventing this disease. Pay attention to strengthen nutrition during pregnancy, eat more fruits and vegetables to supplement enough vitamins, maintain good mood and appropriate activities to improve physical fitness are conducive to the development of the fetus in the right direction.
Complication
Bladder diverticulum complications Complications bladder stones
Most of the diverticulum is located at the bottom and sides of the bladder. The wall is weak. It can be infiltrated by inflammatory cells. It can also be complicated with stones and tumors. The diverticulum can also compress the ureter to cause obstruction. If the obstruction develops further, it can be due to the capsule. Increased internal pressure causes a decrease in glomerular filtration rate, decreased urine output, and impaired creatinine and urea nitrogen excretion. In severe cases, renal insufficiency or renal failure may occur.
Symptom
Bladder diverticulum symptoms common symptoms dysuria and urinary retention urinary urgency frequent urination pain tibia dysplasia renal failure hematuria constipation
If there is no complication, there are no special symptoms in the bladder diverticulum. If there is obstruction, infection, dysuria, frequent urination, urgency, urinary tract infection symptoms, some diverticulum can be as large as 2000ml, oppress the bladder neck and urethra, leading to lower urinary tract Obstruction, diverticulum without muscle contraction, etc. lead to poor drainage of the urine, easy to accompany ureteral bladder reflux, may appear one or both sides of hydronephrosis, eventually leading to renal failure, but also congenital huge diverticulum does not co-ordinate urinary tract Obstruction, due to the small muscle fibers in the bladder diverticulum, during the urination, huge urine can not be discharged indoors, there are secondary urination symptoms, some patients with infections in the sputum, stones with hematuria, a small number of patients due to huge diverticulum It is located in the bladder neck and compresses the bladder outlet to produce urinary retention, which presses the rectum and causes constipation. It presses the uterus and causes dystocia.
Examine
Examination of the bladder diverticulum
Intravenous urography can show displacement of the diverticulum or ureter, but the most effective method is oblique or lateral urinary bladder urethra angiography. Re-photographing after bladder emptying can help to further confirm the diagnosis, also in the bladder filling and urination. After the B-mode ultrasound examination is also helpful for diagnosis, cystoscopy can see the relationship between the opening of the diverticulum and the ureteral opening, can be extended into the sputum to understand the presence or absence of stones, tumors.
Diagnosis
Diagnosis and diagnosis of bladder diverticulum
diagnosis
Generally no special symptoms, such as combined with obstruction, infection, dysuria, frequent urination, urgency, dysuria, some hematuria, large diverticulum can appear two urinary symptoms, the characteristic manifestations of this disease, combined with imaging examination , endoscopy can confirm the diagnosis.
Differential diagnosis
1. Ureteral diverticulum: There are also urinary tract irritation, urgency, dysuria and other urinary tract irritation symptoms. When the diverticulum is large, the sacral mass can also be blocked. But B-ultrasound shows that the cystic mass is outside the bladder outline, and the lower end of the ureter is The diverticulum can be extended by B-ultrasound, CT, MRI combined with excretory or retrograde urography, showing the location of the diverticulum, and the ureteral dilatation can be seen above the diverticulum.
2. Urethral diverticulum: There are also two urinations, but cystography and urinary bladder urethrography can show that there is no diverticulum in the bladder, cystic mass in the urethra, urethroscopic examination shows that the diverticulum is in the urethra rather than in the bladder.
3. Benign prostatic hyperplasia: There may be segmental urination, some patients may have pseudo-diverticulum, but the patient is older, the symptoms are frequent urination, urgency, especially at night, the rectal examination increases prostate volume, central ditch Lightening, B-ultrasound, CT can show enlarged prostate, bulge, abnormal urine flow rate.
4. Repeated bladder: B-ultrasound and CT examination showed that the bladder has intact muscle layer and mucous membrane, and there is separation in the bladder or two intact bladders by urethrography and cystoscopy.
