tuberculous bladder contracture
Introduction
Introduction to tuberculous bladder contracture Tuberculous bladder contracture is a tuberculosis secondary to renal tuberculosis. Tuberculous nodules can fuse with each other to form ulcers. Ulcers can invade the bladder muscle layer, causing severe extensive fibrous tissue hyperplasia, which makes the bladder muscles lose their ability to expand and contract, and the capacity is reduced. When the bladder capacity is less than 50 ml, it is clinically called a contracture bladder. Tuberculous bladder contracture is a relatively common late complication of renal tuberculosis and is the main cause of contralateral hydronephrosis. basic knowledge The proportion of illness: the incidence rate of tuberculosis patients is about 3-5% Susceptible people: no specific population Mode of infection: non-infectious Complications: hematuria
Cause
Cause of tuberculous bladder contracture
Mycobacterium tuberculosis infection (50%):
The cause of bladder contracture is that tubercle bacilli from kidney tuberculosis often repeatedly invade the bladder, causing severe tuberculous cystitis, causing congestion and edema, tuberculous nodules, tuberculosis ulcers, tuberculous granulation in the mucosal bladder muscle layer of the bladder. A large amount of lymphocyte infiltration and fibrous tissue formation eventually caused bladder contracture. After bladder contracture, the bladder wall loses its normal elasticity and its capacity is significantly reduced. It is generally believed that the volume of the contracted bladder is below 50 ml. In severe cases, the bladder can be retracted to a few milliliters of capacity. Because the bladder is often repeatedly infected by Mycobacterium tuberculosis, the pathological changes in the bladder are acute and chronic, and the coexistence of inflammation and fibrosis.
Prevention
Tuberculous bladder contracture prevention
Comprehensively popularize infectious disease knowledge, do a good job in prevention of infectious diseases, and actively treat systemic tuberculosis. Tuberculosis treatment must be standardized to avoid repeated attacks to induce this disease. In the course of treatment, the principles of early, full, joint, appropriate, and standardized should be followed to avoid drug resistance caused by leakage. The course of treatment is usually 6-9 months, so it is necessary to have confidence and patience. Ordinary combined with regular treatment, the prognosis is good. .
Complication
Tuberculous bladder contracture complications Complications
Often combined with urinary pain, pyuria, hematuria and other symptoms.
Symptom
Tuberculous bladder contracture symptoms Common symptoms Urinary incontinence and enuresis Urinary incontinence Urinary pain Bladder tuberculosis No pyuria Urine hematuria
1. Significant urination, each time the amount of urine is very small, severe cases of urinary incontinence; more accompanied by dysuria, pyuria, hematuria and so on.
2. When the contralateral kidney is filled with water, the upper abdomen touches the mass.
3. Chronic renal insufficiency symptoms occur in severe cases.
Examine
Tuberculous bladder contracture examination
In the urine routine test, when the inflammatory sputum of bladder tuberculosis, the degree of pyuria and hematuria is basically the same as the frequency of urination, while the urinary frequency is significant in bladder contracture, but there are not many inflammatory cells in the urine. In cystography, bladder tuberculosis Inflammatory sputum is not painful when injecting contrast agent, the bladder shape can be normal, or it is folded and has bladder neck spasm; while bladder contracture patients do not hurt when injecting contrast agent, only the feeling of bulging, the bladder is very small, The edges are not smooth and are not folded. In severe cases, the bladder neck is opened and the posterior urethra is dilated.
Diagnosis
Diagnosis and diagnosis of tuberculous bladder contracture
Diagnose based on
1. History of kidney tuberculosis.
2. Significant urination, each time the amount of urine is very small, and severe cases have urinary incontinence.
3. The upper abdomen can touch the enlarged kidney.
4. Late chronic renal insufficiency symptoms.
5. Bladder angiography showed that the bladder capacity was reduced, it was round, and the edge was irregular. The contrast agent could flow back to the ureter and renal pelvis through the ureteral orifice.
The diagnosis of tuberculous bladder contracture is mainly based on clinical symptoms, urine tests, and cystography, and should be differentiated from inflammatory sputum caused by bladder tuberculosis. In terms of clinical symptoms, inflammatory sputum caused by bladder tuberculosis is often excluded. There are dysuria, pyuria, hematuria, etc., after anti-tuberculosis treatment can be improved, and the symptoms of bladder contracture in addition to frequent urination and urinary incontinence, often no dysuria, pyuria, hematuria, etc., after anti-tuberculosis treatment symptoms can not be improved, sometimes due to Further fibrosis of the bladder lesions, the symptoms are aggravated, in the urine routine test, the inflammatory sputum of bladder tuberculosis, the degree of pyuria and hematuria is basically the same as the frequency of urination, while the urinary frequency of the bladder contracture is significant, but the urinary inflammatory cells Not much, in terms of cystography, the inflammatory sputum of bladder tuberculosis does not hurt when injecting contrast agent, the bladder shape can be normal, or it is folded and has bladder neck spasm; while bladder contracture patients do not hurt when injecting contrast agent, only There is a feeling of bloating, the bladder is very small, the edges are not smooth, and it is not folded. The bladder of the bladder is opened and the posterior urethra is dilated. It can be used for identification saddle hemp; inflammation caused by bladder tuberculosis spastic bladder capacity can be expanded in the saddle anesthesia, and bladder contracture is still not be expanded.
