Glandular or cystic cystitis

Introduction Glandular or cystic cystitis is characterized by bladder mucosal edema, which has adenoid structural hyperplasia and many inflammatory cell infiltration. Patients are more common in middle-aged women. Therapeutic application of antibacterial drugs requires the removal of pathogenic factors. Glandular cystitis is a transformed lesion of the bladder mucosal transitional epithelium that is transformed into glandular epithelium for various reasons. Its clinical manifestations are not characteristic. The clinical manifestations of cystitis glandularis are urinary frequency, urgency, dysuria, dysuria, gross or microscopic hematuria. If there is hydronephrosis, there may be symptoms such as backache and waist swelling. The diagnosis is mainly based on cystoscopy and biopsy.

Cause

Under the action of chronic stimuli, the transitional epithelial tissue is transformed into glandular epithelium, which is secreted by mucus to achieve its own protection. Some speculate that there may be vitamin deficiency, allergic reaction, toxic metabolism, product, hormone imbalance and special carcinogens. Common chronic stimuli include infection, obstruction, physical stimuli (stones, foreign bodies, etc.) and chemical carcinogens.

an examination

Related inspection

Bladder ultrasound cystography

In imaging examination, B-ultrasonography, IVU, and CT can detect bladder-occupying lesions, but there is no specificity; the diagnosis is mainly based on cystoscopy plus biopsy.

Cystoscopy can be seen: 1 follicular edema, manifested as flaky infiltrating follicular edema or villous hyperplasia; 2 bladder mucosal papillary hyperplasia, pedicled nipple, congestion and edema; 3 chronic inflammation, The local mucosal roughness, vascular texture increased and blurred; 4 mucosa did not change significantly. Among them, papillary lesions and papillary tumors of the bladder are difficult to distinguish. Careful observation shows that the papillary mass of the cystitis glandularis is translucent and has no vascular access, while the papillary tumor of the bladder is opaque and visible with blood vessels entering the nipple. However, the diagnosis can only be based on biopsy.

Differential diagnosis

It should be differentiated from the symptoms of the bladder:

1. Bladder fibrosis: Bladder fibrosis refers to the increase of fibrous connective tissue in the bladder tissue, the reduction of parenchymal cells, and the continuous progression can lead to organ structural damage and dysfunction, and even exhaustion, which seriously threatens human health and life.

2. Bladder irritation: Acute cystitis is mainly caused by Escherichia coli (usually Escherichia), but is rarely caused by Gram-positive aerobic bacteria (S. parasitica and Enterococcus). The infection is often caused by the urethra going up to the bladder. Girls and women are more susceptible to cystitis than boys and adult men. In children, adenovirus infection can cause hemorrhagic cystitis, but it is rare in adults with viral cystitis. There are obvious bladder irritation: frequent urination, urgency, nocturia, urinary burning or dysuria.

3. Bladder dysfunction: Control of urinary dysfunction caused by damage to the central or peripheral nerves of urination.

4. Acute cystitis: The symptoms are more typical, and the general diagnosis is not difficult. According to the history of frequent urination, urgency and dysuria, urine can be seen in routine examination of urine, pus cells, urine bacteria culture per ml of urine bacteria count more than 100,000 to confirm the diagnosis.

5. Chronic cystitis: many other diseases secondary to the genitourinary system. Therefore, in addition to the general examination of the system, the most important thing is to find out the types of pathogenic bacteria and the results of drug sensitivity tests, to find the cause of infection or The cause of the recurrence. Chronic non-specific cystitis must be differentiated from specific cystitis, such as tuberculous cystitis, interstitial cystitis, and trichomonas, fungal cystitis.

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