Symptom >> Internal Medicine >> Urology

Huge bladder

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The huge bladder-large ureteral syndrome, also known as the huge bladder, has a large ureteral sign, which is characterized by a huge thickening of the bladder-ureter, but no urinary tract obstruction and vesicoureteral reflux, and no urinary tract obstruction. Some people think that a huge bladder or a huge ureter should be diagnosed as a separate disease. With the advancement of inspection techniques, it has been found that the expanded bladder is also reversible, and the ureteral dilatation is also reversible. Regarding the view of no urinary tract obstruction, obstruction is also found.

Cause

Cause

1. Decreased parasympathetic ganglion cells in the distal ureter wall.

Decreased, hypoplasia or absence of parasympathetic ganglion cells in the distal ureter wall resulted in loss of ureteral peristalsis and functional obstruction, but it was not confirmed by histology.

2. The end longitudinal muscle of the ureteral wall is lacking (normal ring muscle), thus causing functional obstruction, and it is believed that the longitudinal muscle deficiency is caused by the compression of the ureter in the middle kidney tube 12 weeks after the embryo.

3. Abnormal collagen fibers in the distal ureteral muscle layer

The distal ureter muscle layer and nerve are normal, but abnormal collagen fibers in the muscle layer interfere with the stratified cell layer arrangement, which hinders the transmission of peristaltic waves and produces functional obstruction. These are all further studies to be organized.

4. Genetic factors

There are also reports of mother and daughter suffering from this disease, so whether there is a family genetic predisposition remains to be studied.

Examine

an examination

Related inspection

Urinary routine urinary tract urography bladder injection

According to the clinical occurrence of recurrent urinary tract infections, combined with intravenous secretory angiography and cystography, a preliminary diagnosis can be made. The diagnostic conditions proposed by Tongji Xinfu are:

1 congenital.

2 bilateral ureteral dilatation.

3 bladder expansion.

4 irreversible.

5 no urinary tract obstruction.

6 no neurogenic bladder.

7 no dysuria.

Diagnosis

Differential diagnosis

Obstructive giant ureter

Congenital ureteral stricture, valve, atresia, ectopic opening, etc., acquired ureteral polyps, stones, infection, trauma, etc., can cause obstructive giant ureter.

2. Reflux giant ureter

Primary or secondary vesicoureteral reflux, such as secondary congenital posterior urethral valve, urethral stricture, urethral diverticulum, neurogenic bladder, lower urinary tract obstruction. It is difficult to distinguish the neurogenic bladder from the disease.

3. Secondary non-obstructive giant ureter

Such as diabetes, diabetes insipidus, etc., long-term polyuria leads to ureteral dilatation. In order to identify the neurogenic bladder, ureteral electromyography and X-ray TV can be used to continuously demonstrate the motility of the ureter. In addition, cystoscopy and cystography can be performed to confirm the presence or absence of lower urinary tract obstruction.