bladder spasm
Introduction
Introduction The definition of bladder spasm in medicine refers to the contraction of bladder smooth muscle or bladder sphincter without inflammatory changes. The clinical manifestations are mainly characterized by urinary dripping, temporary closed urine and urinary abdominal pain. Bladder spasm is also a common complication after urologic surgery. Patients with acute bacterial cystitis often develop symptoms such as bladder spasm. Acute bacterial cystitis is a common urinary tract infection caused by bacterial infection, and most of its pathogens are Escherichia coli.
Cause
Cause
First, the anatomical structure of the female urethra is short and straight, the common external urethra deformity, such as the hymen umbrella, urethra hymen fusion; and the perineum has a large number of bacteria, as long as there are incentives for infection, such as sexual intercourse, catheterization, personal hygiene is not clean , individuals with reduced resistance to bacteria, etc., can be roughly ascending infection. It is rarely caused by blood infections and lymphatic infections.
Male urethra is a muscle mucosa tube, about 20cm long, can be divided into two sections, with urinary genital warts as the boundary, there are two pubic pubic and pubic bones, so it is generally not easy to cause ascending infection, often secondary to other lesions. Such as acute prostatitis, benign prostatic hyperplasia, dermatitis, urethral stricture, urinary stones, kidney infections, etc., can also be secondary to adjacent organ infections such as abscess around the appendix.
Second, estrogen deficiency in menopausal women often occur in urinary tract infections, due to the lack of estrogen caused by decreased intravaginal lactobacilli and increased growth of pathogenic bacteria is an important factor in infection.
3. Most of the pathogenic bacteria are Escherichia coli. Other rare examples are E. coli, Proteus, Pseudomonas aeruginosa, Streptococcus faecalis, and Staphylococcus aureus. In children, adenovirus infection can cause hemorrhagic cystitis, but it is rare in adults with viral cystitis.
Pathological changes superficial cystitis is more common, with the most obvious urethral mouth and bladder triangle. In the early stage of acute cystitis, the bladder mucosa is hyperemia and edema, which is dark red with leukocyte infiltration. In the later stage, the mucosal fragility is increased, and it is easy to hemorrhage. The surface is granular, and there are superficial ulcers or abscess coverings, containing exudates. Usually does not involve the muscle layer. Inflammation has a tendency to heal itself, leaving no trace after healing. If the treatment is not complete or there are foreign bodies, residual urine, upper urinary tract infection, etc., it is easy to turn chronic. Do not leave any traces. If the treatment is not complete or there are foreign bodies, residual urine, upper urinary tract infection, etc., it is easy to turn chronic.
Examine
an examination
Related inspection
Cystoscopy, ureteral reflux, cystoscopy, cystography
First, laboratory inspection:
The blood is normal, or there is a slight increase in white blood cells. Urine analysis often has pyuria or bacteriuria, and sometimes hematuria or microscopic hematuria can be found. Pathogenic bacteria can be found in urine culture. If there are no other urinary diseases, serum creatinine and blood urea nitrogen are normal.
Second, X-ray inspection:
If kidney infection or other genitourinary tract abnormalities are suspected, an X-ray examination is required. For patients with Proteus infection, if the treatment effect is poor or no effect at all, X-ray examination should be performed to determine whether there is a urinary calculi.
Third, the equipment inspection:
When the bleeding is obvious, cystoscopy should be performed, but it must be done after the acute phase of infection or after the infection has been adequately treated.
Diagnosis
Differential diagnosis
Differential diagnosis of bladder spasm:
Acute pyelonephritis and acute bacterial cystitis have common urinary symptoms, namely frequent urination, urgency, dysuria, and laboratory tests can see white blood cells and red blood cells in the urine, and urine bacteria tests are positive. Therefore, it is especially important for the treatment to make a differential diagnosis between the two.
First, acute pyelonephritis is more common in women. It usually has a history of urinary calculi obstruction or a bladder-ureteral reflux. However, acute cystitis can occur in both men and women. The cause is closely related to gynecological inflammation, while men are often On the basis of prostatitis, drinking or sexual intercourse is the main cause.
Secondly, the incidence of acute pyelonephritis is relatively lower than acute cystitis, but acute pyelonephritis often has more obvious systemic symptoms. It is characterized by elevated body temperature, total white blood cells and elevated neutrophils, often accompanied by fever. Aversion to chills, sore muscles, headache, nausea and vomiting, loss of appetite, etc.; and acute cystitis, except for severe urinary tract irritation (ie frequent urination, urgency, etc.) and urinary tract burning when urinating, there is no obvious systemic symptoms. Those who seem to be "healthy" can work and study as usual, and their blood routines are not abnormal.
Third, acute pyelonephritis may have rib angle or lumbar tenderness and snoring pain, mostly one-sided; while acute cystitis often has tenderness in the bladder area, a few have tenderness in the epididymis, suggesting that the infection originates from the epididymis and prostate. .
Fourth, acute pyelonephritis requires intensive hospitalization, rest in bed for 1 to 2 weeks, support and symptomatic treatment, you must choose the appropriate antibacterial drugs to achieve effective tissue and serum concentrations, that is, early, joint, effective and full use of antibiotics In order to prevent the conversion to chronic pyelonephritis due to improper treatment; most of the acute cystitis does not require hospitalization and bed rest, pay attention to drinking water to promote urination and drainage, appropriate infusion and short-term administration of antibiotics (ie 3 days of therapy), most patients The condition can be relieved quickly, and some patients need to be given a 2-week treatment.
