Anomalies of the bladder: congenital disease
Among urological diseases occupy a special place anomalies of the bladder. It is a congenital pathology, developing during the formation of the child in the womb. The main causes of the anomalies considered to be hereditary factor, bad ecology, transferred by the mother during pregnancy, infectious diseases, the use by mother of alcohol and drugs, occupational hazard. The result developed various vices. Some of them are incompatible with life.
Agenesis: anomaly congenital absence of the bladder in the newborn
Malformations of the bladder are congenital or acquired in nature.
Agenesis denote ugliness in which a particular organ is missing. Agenesis of the bladder is a rare pathology. According to statistics, from 19046 stillborn or died in early childhood, infants, 7 were found on the autopsy this anomaly. Pathology occurs due to incomplete development of the cloaca or allatps. Accompanied by atresia of the rectum and vagina, absence of the urethra. This defect is incompatible with life. However, upon further development of medicine in the future, the absence will be treated by transplantation of the bladder. Currently, the problem is solved by the elimination of the ureters into the intestine.
The doubling of the bladder is characterized by the separation of majevica into 2 parts by a partition, which may take place in two directions (along or across). Pathology happens:
- Full. Mocevic divided into 2 compartments, independent of each other. Each of them has its own ureter, cervix, and separate the urethra.
- Incomplete doubling. Both compartments come in a single cervix and the urethra.
Is incomplete division of the authority. This phenomenon is called two-chamber bladder. During the ultrasound diagnosis of this defect can be adopted for a large diverticulum. The main symptoms of an anomaly, urinary incontinence and chronic inflammatory processes such as cystitis, pyelonephritis. The treatment is excision of the septum through surgical intervention.
Protrusion of the bladder wall are called diverticulum. Like any pathology, the disease disrupts the normal operations of majevica, causing more complications. The anomaly there is no pronounced symptoms, because it can be difficult to diagnose. This is the danger of the disease: complications are to determine pathology. The diverticulum becomes stagnant urine is formed, pathogenic microorganisms, it affects the mucous membranes of the bladder. All this contributes to the development of inflammatory processes. Pathology is eliminated surgically.
Any deviation from the norm in the structure of the bladder requires immediate treatment. Otherwise you develop a serious complication with poor prognosis.
Congenital hypertrophy of the detrusor
Hypertrophy of the detrusor — the muscle of the bladder, through which urine is expelled and is urination. Congenital anomalies in addition to the detrusor has no associated anomalies, the state of urodynamics, urethra, etc. is normal. In order to avoid later complications it is necessary to remove the underdeveloped muscle and replace it with a loop of intestine.
In the absence of treatment the child has difficulty with urination, the bladder is not completely emptied. Newborn becomes restless, straining. Over time, macelike going to a large volume of urine, as the detrusor is unable to handle the load. In the result, the bladder is stretched, there is atrophy and subsequent atony of the organ.
Bladder extrophy — underdevelopment of the urogenital system. Considered the most severe form of anomalies in urology. The disease is characterized by lack of abdominal wall and bladder wall. Is determined immediately after the birth of the child. Due to the difference of pressure mocevic turned inside out, urine flows through the abdomen. There are often comorbidities: epispadia (underdevelopment, dissection of the urethra), the splitting of the pubic bone. Among the 30-50 thousand births only one diagnosed with this pathology, girls 2x more than boys. If a woman has a first child born with this abnormality, the probability of having this problem have a second child increases (1:100).
Contracture of the bladder neck
The disease is called stenosis of the bladder neck or the illness of Marion. A rare malformation of the bladder, described in 1935, a hallmark of disease — a developmental disorder of connective tissue, in the mucosa and in the muscular layer of the bladder neck is formed an abnormally large amount of fibrous tissue. There are cases of disease involving a large area of the body. Often suffer from this disease boys.
The main symptoms
The manifestation of the disease depends on the extent of damage and its duration:
- When mild contracture children have difficulty in urination or the disease does not manifest itself until the occurrence of concomitant diseases and complications.
- Severe pathology and/or duration of the disease is characterized by shortness of urination, residual urine remains mocovice.
- The lack/delay of urination.
- Frequent infectious diseases of the urinary tract.
- In the case of complications of hydronephrosis pathology and diagnosis of this phenomenon in a child before birth, predict a difficult birth.
- If treatment was not initiated, develops renal failure.
Diagnosis of congenital diseases
To establish a correct diagnosis, carry out instrumental examination:
- Cystoscopy identifies trabecular bladder. The phenomenon occurs when there is difficulty urinating and represents abnormal development of certain muscle fibers of majevica, between which are formed the trench, the false diverticula.
- Retrograde pyelography revealed the tortuosity and enlargement of the ureter, vesicoureteral reflux.
- The diagnosis is confirmed by uroflowmetry showing the condition of the neck of majevica.
Treatment of abnormalities is possible only through surgical intervention. The surgery is performed endoscopically, i.e. through the urethra. The affected bladder neck cut, is it plastic. Along with this, require therapy of concomitant inflammatory processes that occur as a complications, eliminating toxicity.
Urogram is called a tube connecting the urinary bladder of the embryo with the umbilical cord. Due to this, the urine of the fetus is excreted into the amniotic fluid. On the fifth month of pregnancy starts the process of formation full urinary system of the child, and this channel is overgrown. Sometimes this does not happen, the child is born with an abnormality of urachus. After the falling away of the umbilical cord revealed a fistula from which urine drips. Pathology is usually diagnosed in children up to 5 years, but there are cases when the pathology of the bladder is manifested in the elderly. In women is less common. There are 2 types of this anomaly.
With the full opening of urachus pathological changes in the structure of the child is seen immediately after birth, because from the navel stands out with urine. If the diameter of the duct is small, mainly urine is excreted through the urethra. If you flatten the belly of the child, there is an intensive release of urine from the navel. The disease is diagnosed through cystoscopy and cystography. Introduced into the bladder, the probe shows the hole uncovered urachus. Another method is the introduction of mocevic through a catheter colored liquid. Its isolation from the umbilicus confirms the type and feature of the Vice.
Depending on the place of cleft defect are divided into 3 types:
- Umbilical fistula. Urachus does not grow from the top. The problem is detected after the child is no longer the umbilical cord or at any other age. If pathology is manifest in an adult, it can be argued about infectious defeat of urachus, which has led to suppuration and break through the navel.
- The formation of cysts. The pathology Department of the middle duct. Manifested by the presence of tumors, which is independent or belongs to the bladder or umbilicus.
- The diverticulum. Nezareatmene the bottom of the division. Manifested after infection. The patient complains of abdominal pain, painful urination with frequent urging. By means of cystoscopy at the top of majevica found the course in neurosci duct (diverticular). The diverticulum is observed suppuration, the pus enters mocevic.
The treatment of anomalies of the bladder is performed only surgically.
With the full opening of urachus cut. The operation is performed not later than a few months after birth into the light to prevent the penetration of infection. Basically the procedure is performed a few days after birth. In case of partial opening in the first year of a baby’s life, surgery is not performed. There are cases of self-closure of the fistula within the first months of baby’s life.
If the operation is delayed, the child’s mother holds conservative therapy. In the hospital the woman to carry out instructions. The goal of therapy is to prevent infection. Navel systematically treated with antiseptic solutions. Baby do baths with a solution of potassium permanganate. Surgical intervention is performed when the child is well enough and he will be one year. Depending on the situation and remove the navel and Uranus, but more often only the fistula.