Bladder diverticulum .Diverticulitis .- Causes, Symptoms and Treatment .MF .
diverticulum of the bladder - is the protrusion of an organ wall to form a bag-shaped reservoir in which urine is stored.Plural formation of diverticula in the bladder wall is called diverticulosis.
Causes of urinary bladder diverticula
In its origin diveritikuly bladder may be congenital or acquired.Congenital diverticula are called true, since their wall consists of all layers of the bladder.Their causes may be different chromosomal abnormalities, the clinical picture is characterized by multiple malformations, including urogenital system.
Acquired diverticula are called false, as they differ from the wall of the bladder wall lack of muscle layer.The cause of false diverticula is the pressure in the bladder, which increases with urinary retention.This can occur in diseases such as prostatic adenoma, prostate cancer or urolithiasis.The mechanism of acquired diverticula is that the urinary retention develops compensatory hypertrophy of the muscle wall of the bladder.Further in one location begins to
addition, acquired diverticula of the bladder may be a consequence of the injury of the body.The most common cause of this pathology is the blunt trauma of the bladder, in which there is no violation of the integrity of its lumen.
Symptoms of urinary bladder diverticula
As a rule, the presence of urinary bladder diverticula is not accompanied by clinical signs of bright, which significantly complicates the process of diagnosis.Specific symptoms in this pathology is considered to be a feeling of incomplete emptying of the bladder and urine twice.These symptoms develop due to the fact that part of the urine does not go along the urethra, and remains in the cavity diverticulum.After emptying the bladder diverticulum of liquid enters into its cavity, which leads to an additional urine sample.
Brighter clinical symptoms may develop complications of bladder diverticulum.Quite often, in the last cavity and may be formed stones tumor.This leads to lower abdominal pain, redness or clouding of urine.
diagnosis of urinary bladder diverticula
Laboratory blood and urine only changed if these complications of diverticula.This may be the presence of blood or salts in the general analysis of urine.In all other cases, laboratory blood counts remain absolutely calm.
plain radiography of the abdominal cavity, as a rule, does not give any result in relation to the diagnosis of urinary bladder diverticula, so its holding for suspected this pathology is considered inappropriate.
reliable method of verification of the diagnosis is cystography, which is the introduction of contrast medium into the cavity of the bladder, followed by X-rays.In the picture is visualized with bladder tumor protrusion on one of its walls.Screening reception at the diverticulum is the act of urination.If after this tumor protrusion disappears, it really is a diverticulum.
diverticulum bladder cystography
Exactly the same principle can be used, and excretory urography.The only difference in its performance is that in this case, the contrast is not introduced through the urethra, and intravenously.Generally, excretory urography satisfied in the case where it is necessary to exclude the kidneys and ureters pathology or confirm the diagnosis of bladder diverticulum.
more modern and more reliable method of diagnosis of bladder diverticula is cystoscopy.It involves examination of the bladder mucosa via a special optical device, which is inserted through the urethra.Visually diverticulum bladder looks like an extra turn which opens into the blind cavity.
Ultrasonography, which is also recommended for all patients with suspected urinary bladder diverticula, can show the presence of an additional education in a basin filled with liquid.
In some cases, when there is a possibility, it is possible to carry out a CT scan of the pelvic organs.The pictures will be visualized education, deriving from the bladder wall, equal to him in consistency.To confirm the diagnosis, you can perform a CT scan with enhancement, ie with contrast.
Treatment of urinary bladder diverticula
main method of treatment of urinary bladder diverticula is surgery.The volume of transactions is to remove the dressing or bag-shaped protrusions.The indications for surgery are complicated forms diverticula, which are the causes of urolithiasis, urinary retention, or cystitis.
Surgery to remove the diverticulum
addition, the tactics of treatment of diverticula (meaning acquired) should include measures to address the causes that led to urinary retention.This operation may be to remove stones, tumors or prostatic adenoma.
Because quite often after surgeries on developing bladder cystitis, patients assigned intravenous and intravesical administration of antiseptics, which mainly affect the urinary tract flora.To date, among these pharmaceuticals can be identified FURAMAG or furadonin.They can be purchased at the pharmacy with a prescription physician.
In the case of uncomplicated diverticular used expectant management, which is an outpatient monitoring of patients.Quite often it happens that a diverticulum does not progress and does not affect the patient's health.Such cases are usually not needed in the treatment.
Treatment folk remedies
Treatment folk remedies, as a rule, does not give any effect.When urinary retention, traditional medicine recommends the use of diuretics.The latter leads to the formation of large amounts of urine, which is still retained in the bladder.Thus, the traditional methods of treatment do not have any positive effect in the treatment of urinary bladder diverticula.
Feeding habits and way of life
To release the pressure in the cavity of the bladder to prevent the recurrence of diverticulitis, and differences of postoperative wound, the patient is recommended setting a urethral catheter.Patients explain the rules of care for the catheter.The latter should at least once a week to change a new one.In addition, the urine tank must be constantly ravage the order, did not happen reverse casting fluid into the bladder and secondary infection.
Also in the cavity of the bladder by a urethral catheter is constantly introduced antiseptic solutions that prevent infection associated with urethral catheter.
Postoperatively, the patient is assigned to a special diet, lowering the acidity of urine.This is done with a view to the wound heal faster bladder.The diet of patients excluded any alcohol and salty foods, which leads to an increase in urine acidity.
rehabilitation after illness
As already mentioned, even in the postoperative period, patients in need of intravesical solution antiseptics.This is done in order to prevent secondary infection and rapid wound healing.
addition, quite often the patient to a speedy recovery appointed physiotherapy as UHF.They may be both general and local.In the case of the latter, a special urethral probe.
Complications of bladder diverticula
most common complication of bladder diverticula is considered cystitis.It develops due to stagnation of urine in the oral diverticulum.Mucositis is first localized in the diverticulum, and later extended to the rest of the mucosa.For the same reason, it may develop kidney stones.With the development of the latest patients complain of persistent pain in the lower abdomen as when urinating and at rest.Urine in this pathology will melt more turbid than normal, and sometimes has a red blood sludge.
cases where the tumor has developed this body because of the diverticulum of the bladder is also described in the literature.
much greater number of complications in urinary bladder diverticula develop after surgery.Firstly, because of poor antibiotic treatment may develop postoperative cystitis with suppuration surgical wound.Also, due to inadequate decompression chamber of the bladder may occur and re-occur diverticulum bladder rupture at the seams.
Prevention of urinary bladder diverticula
Prevention of congenital diverticula, as well as other hereditary diseases, are not fully developed.Expectant parents are advised to refrain from drinking alcoholic beverages, diagnosis and treatment of infectious diseases, which can affect the development of the fetus, as well as healthy eating.
Prevention acquired diverticula should be primarily in the treatment of those diseases that can lead to increased pressure within the bladder.Typically, this prostate adenoma or cancer of the body.Also, there are times when diverticula arise from the bladder stone that blocked the opening of the urethra.In this situation, the greatest role in causing protrusion in the bladder wall is played sharp increase in pressure to which the bladder has not time to adapt.
If you can not carry out radical treatment of prostate diseases, then for the prevention of urinary bladder diverticula produced staging urethral catheter, which can relieve the bladder up to the time of the operation.
Ed.urologist Astashin EE