urethral mucosal prolapse
Introduction
Introduction to urethral mucosal prolapse Urethral mucosal prolapse, also known as urethral mucosa valgus, is a female urethra disease in which the urethral mucosa and submucosal tissue are removed and turned over outside the urethra. The majority of the cases are children, followed by menopausal women. basic knowledge Sickness ratio: 0.0001% Susceptible population: Most of the patients are children, followed by menopausal women. Mode of infection: non-infectious Complications: urinary tract infection
Cause
Causes of urethral mucosal prolapse
Female pelvis rapidly increases and pelvic organs change (30%):
The real cause is still not very clear. It is believed that children with urethral mucosal prolapse are seen in frail girls, which are associated with rapid increase of pelvis and changes in pelvic organs. In addition, weak urogenital sputum, congenital defects of urethral mucosa and submucosal adhesion, easy Mucosal prolapse occurs, and prolapse of elderly women may be due to childbirth injury, decreased estrogen levels after menopause, atrophy of tissues around the urethra, or weakened urethra, and the tissue around the urethra is loosened and the urethral mucosa is turned out.
Cough, constipation, diarrhea (25%):
In addition, various reasons such as severe cough, constipation, diarrhea, childbirth, urinary tract infection, weight bearing, etc., cause bladder pressure to be too high, resulting in imbalance of bladder and urethral pressure, combined with insufficient support tissue around the urethra, can also lead to the occurrence of this disease, other Direct compression such as bladder stones, urethral stones or tumors can also be induced.
Urethral mucosa is weak (25%):
The female urethra is vertically downward, short and wide. If the muscular layer of the muscle layer is weak, the surrounding tissue is loose, the mucosa develops beyond the muscle layer, and the urethral mucosa, especially the posterior wall, is turned down out of the urethra to form a partial urethral mucosal prolapse. The urethral wall is also loose, and the entire urethral mucosa is prolapsed to form complete urethral mucosal prolapse. The prolapsed mucosa is compressed by the urethral orifice, the clothing is stimulated by friction and edema, and even embolism and necrosis. It can also be infected and eroded.
Prevention
Urethral mucosal prolapse prevention
First, prevention:
1. Pay attention to local hygiene and prevent infection: especially for elderly women, educate them about the importance of wiping the genitals after urinating, and clean the genitals on time to prevent genital bacteria from infecting the urethra.
2, to prevent constipation: eat more foods rich in cellulose, such as celery, cereals, etc., drink plenty of water to lubricate the intestines.
Complication
Urethral mucosal prolapse complications Complications, urinary tract infections
1, urethral obstruction: visible ring or semi-annular purple red mass prolapse, the urethral opening is located in the center of the mass, inserted into the catheter to see urine outflow. In severe cases, it may be accompanied by infection, erosion, flaky necrosis or adhesion of pus moss, bloody serous secretions and odor, and lumps leading to urethral obstruction.
2, urinary tract infection: due to the increased sensitivity of the elderly urinary tract epithelial cells to bacteria adhesion, especially in women, some speculation may be related to changes in estrogen levels, estrogen stimulation may increase the bacterial receptors on the cell surface Density and increased cell adhesion activity, coupled with increased urinary tract obstruction and poor urinary flow in the elderly, is more likely to complicated with urinary tract infection.
Symptom
Urethral mucosal prolapse symptoms Common symptoms Urinary pain, urgency, urinary frequency, male urination, tingling, urethral pain, pus
1. There may be urinary tract irritation such as frequent urination, urgency and painful urination.
2. Hemorrhage at the urethral orifice was found after the bleeding of the urethra. The amount was more or less.
3. The urethral mass can be seen in the ring or semi-annular purplish red mass. The urethral opening is located in the center of the mass. The catheter is inserted into the catheter and there is urine effluent. It can also be accompanied by infection, erosion, flaky necrosis or pus moss adhesion, and bloody serum. Sex secretions and odors.
Examine
Examination of urethral mucosal prolapse
1. Urine routine examination: There may be infection symptoms such as white blood cells and elevated red blood cells.
2. Blood routine: increased blood levels, may have elevated white blood cells, often with neutrophil increased.
3. Urine bacterial culture: If urinary tract infection is suspected, urethral secretions may be smeared or cultured to identify pathogenic bacteria. If the result is positive, it indicates an infection.
Diagnosis
Diagnosis and diagnosis of urethral mucosal prolapse
diagnosis
According to the clinical manifestations can be diagnosed, such as because of prolapsed mucosal swelling covering the urethral orifice is not easy to distinguish, you can observe urination or use urethral probes, catheter catheterization of the urethra is clearly diagnosed.
Differential diagnosis
Ureteral cyst prolapse
The ectopic ureteral cyst is removed from the urethral orifice through the bladder neck and urethra, and becomes a large and purplish red mass, which resembles urethral mucosa prolapse. However, the ureteral cyst is prone to self-reset, and sometimes the ureteral opening can be seen in the cyst. The catheter cannot be inserted from the center of the cyst.
2. Urethral meat
In the same way, the urethral mass is more likely to hemorrhage. In contrast, the urethral meat sputum is small in size, and the base is often attached to the posterior wall of the urethra. After insertion into the catheter, a bright red polypoid mass is seen on the side of the catheter instead of Presents an eversion wrap.
3. Urethral cancer
For the urinary tract mass that is easy to hemorrhage, the urethra can be found to be thickened, hardened, and hardened when the urethra is palpated. The inguinal lymph nodes and distant lymph nodes can be enlarged and enlarged, and the hard signs of metastasis can be confirmed by biopsy. .
4. Bladder prolapse
It refers to the lesion of the bladder through the urethra, which occurs when the abdominal pressure increases. The prolapsed bladder mucosal congestion and edema is dark red, similar to the urethral mucosal prolapse, but the bladder prolapse mass can generally be returned, sometimes visible. The trigone of the bladder and the ureteral opening.
