Diverticulum of the bladder: treatment, causes, symptoms
When in the bladder, notice a small bump, it is diagnosed with diverticulum of the bladder. This pathology is characterized by the formation of a small pouch that bulges forward. In this case there is a violation of urination. it’s hard to go to the toilet, the procedure is accompanied by pain. Delaying the treatment of diverticulosis of the bladder may lead to chronic cystitis, pyelonephritis or urolithiasis.
Diverticulum of the bladder is characterized by the prolapse of its walls, with the formation of pathological saccular cavity. Diverticula of the bladder are connected through the cervix. Pathology leads to difficult urination, a result of developing inflammatory processes in the urogenital system and kidneys.
Diverticula is a rounded saccular protrusion whose size is from 1 to 2 cm.
If this is in the bladder «settled» infection, the bacteria begin to quickly multiply in the walls of the internal organ. This will greatly complicate the situation, there is a need in heavy therapy. It is likely that the bladder will burst, it will lead to a painful surgical pathology. There purulent places, peritonitis and osteomyelitis, in which all bone tissue will be inflamed.
Diverticulum of the bladder may be different, depending on the time of occurrence, location and number of cavities. There are primary and secondary diverticula. The first to appear during fetal development, improper formation of the internal organ or genetic predisposition. Secondary pathology occurs due to the injury of the bladder. Distinguish between multiple and single symptoms of diverticulum of the bladder, it depends on the number of additional cavities. Upon detection of multiple pathology doctor diagnose the diverticulosis bladder. Depending on the structure of distinguish between true and pseudodiverticula (false).
A true congenital diverticulum, a bulge occurs in the fetal age. The diverticular wall is also the wall of the bladder. This is an abnormal saccular formation is connected with the inner on the neck. Most often a true diverticulum located in the posterior surface of the bladder.
A true diverticulum is also filled with the urine, but get her out of there is harder than from the bladder, since it is necessary to cross the isthmus into the inner body. So often, urine is not coming out fully and becomes stagnant. The patient complains of discomfort and a feeling of incomplete emptying. But it does happen, that people do not even suspect the true diverticulum in the body, it does not bother him and does not cause painful sensations.
About or acquired pseudodiverticulum, it appears injuries internal organ. In most cases, doctors diagnose that is a false diverticulum, a true very rare. Very often the reason is the increased pressure inside the bladder or thinning the wall of the inner body. In this form of disease, the main fabric of the bladder is replaced by muscle. Muscle contributes to the outflow of urine, in case of difficulty appears hypertrophy. It’s hard to empty fully. Eventually the problem leads to the fact that the bubbles increase, and the muscles decrease can sometimes be a loosening of the latter. As a result, there was pseudodiverticula bladder.
The causes of pathology
Diverticulum of majevica may occur for completely different reasons. The emergence of the primary contribute to anomalies in the wall in fetal development, weak muscles of the bladder. On the arising pathology is influenced by:
- chemical mutation;
- exposure to radioactive substances;
- infection of the fetus;
- bad habits and unhealthy lifestyle women during childbearing;
- unfavorable environment in the region of residence.
If the pathology is not innate, but acquired, it most often occurs due to improper excretion of urine from the bladder. Pathology contributes to the weak pressure in the inner body. Often caused by malignant tumors in the prostate gland, with adenoma of the prostate or the formation of stones. Due to the accumulation of urine in the internal organ occurs hypertrophy of its muscular wall, which eventually becomes thinner and weaker, and bulging part of the inner body. The causes of acquired diverticula include mechanical trauma to the bladder.
The symptoms of diverticulosis of the bladder
At first the disease makes itself known, especially if it is congenital. Very often, the patient first learns about the disease by chance at ultrasound. Symptoms were not manifested only in the case if the diverticulum there is no stagnation of urine. But if pathology is large, then there is not only stagnation, but other signs:
- painful urination;
- the presence of bleeding in the urine;
- the formation of stones in the bladder;
- break the wall, which threatens to peritonitis.
At the same time the patient notices that urinating is carried out in two stages: first, the urine goes from the bladder, and then a small amount accumulated in the diverticulum. In severe cases, the patient feels pain in the lower abdomen, which is often associated with tumors. Finding all or only some of the above symptoms, should be diagnosed by a qualified doctor. Based on the test results, he will tell you how to treat diverticula of the bladder.
In the event of diverticula of the bladder is disturbed, the pressure in the internal organ. The result is stagnation and inflammatory processes in the urogenital system and adjacent organs. The remainder of the urine and its sediment is a favorable environment for bacteria and infection. If formed sand or stones in the bladder, prescribed medication, but only if the urethra is not occluded.
And so it happened that as a result of complications of pathology in the bladder had tumors. Even though it is extremely rare but they do occur. Complications can occur in the postoperative period. They can cause incorrect anti-bacterial treatment, this will result in cystitis, and surgical wound will be allocated pus. To serve as a postoperative complication and can improper elimination of the cavity of the internal organ, which will lead to relapse.
If you suspect a diverticulum should seek the advice of a urologist. But rarely the patient discovers and comes with this problem. Often, the presence of pathology of the notice it only in the diagnosis of concomitant diseases, such as pyelonephritis or cystitis. To diagnose diverticula are cystography, cystoscopy, computed tomography and ultrasonography of the internal organ.
This procedure is characterized by the examination of the internal body with the help of cystoscope. Through the urethra, the instrument is introduced into the bladder. The process of introduction should be monitored by the urologist under the influence of anesthetic. Cystoscopy allows to detect the isthmus between the diverticulum and the internal body. If the cystoscope to inspect and diverticulum of the bladder, this will allow to know the type and to detect tumors, if such are available.
Ultrasound of the bladder
Making ultrasound diagnostics of the internal organ, it is possible to obtain an informative picture of the pathology. The procedure allows us to determine the location, size and number of the diverticula. Echo shows location relative to surrounding structures and the form of the disease. If there is a tumor or stones, using ultrasound they discovered.
In the process cystography patient’s internal organ filled with a substance that x-ray examination is highlighted. Before the procedure you should empty your bladder. If it is diverticulitis, radio-opaque substance will remain in the diverticulum. On the device it will be displayed in the form of dense shadow, while the body cavity is illuminated brighter.
Treatment: surgery and rehabilitation period
If the symptoms are not particularly evident, and the size of pathology is minor, surgical procedure needed is not. It is important in this case to control the situation together with the urologist and to prevent stagnation of urine. It is possible when the disease apply conservative therapy, but it is inefficient and only addresses the symptoms for a while. It involves flushing the inner body with antiseptics. This method is recommended when preparing for surgery or for patients who are contraindicated for surgery. Surgical intervention is carried out in such cases:
- in the presence of stones or tumors in a diverticulum;
- in the case of severe cystitis;
- if the diverticulum squeezed the neck of majevica and became impossible urination.
Surgery removed or ligated diverticulum of majevica. The complexity and duration of surgical therapy depends on the structure of the internal organ and education. Sometimes necessary plastic mocheotdelenia ways. It is held in that case, if the diverticulum is connected to the ureter.
It is important to remember the rules of rehabilitation that promote complete healing and return to normal life. Should be internal irrigation of the bladder with antiseptics. The procedure is to prevent the re-emergence of bacteria and heals wounds faster. Recommended after surgery to do UHF-therapy, which is conducted through the electromagnetic field. The procedure is a General and local character. In the latter case, use of the urethral sensor.
Eating habits and lifestyle
To prevent the occurrence of diverticula or a recurrence, you should not increase the pressure in the bladder, it is recommended that first time after surgery to use a special catheter. Him need careful maintenance, it is necessary at least once a week to change it. A reservoir for accumulating urine should be emptied after each voiding so the urine did not return. It is important to follow this recommendation to avoid re-infection. Through this catheter is placed antiseptic preparations for washing and disinfection of the internal organ.
The doctor prescribes special diet that did not increase the acidity of urine. Increased acidity interferes with the seam to heal faster. You should eliminate alcoholic drinks, salty foods where the acidity level in urine increases. Adherence to all rules and careful postoperative health care ensure a speedy recovery.
To prevent congenital diverticulum in children prospective parents should refrain from drinking alcohol to cure infectious diseases and to be healthy. Prevention of secondary pathology is the treatment of diseases of the genitourinary system. You need to check the internal body to the presence of stones that block the urethral orifice. In diseases of the prostate is recommended to put a catheter that will reduce the pressure in the bladder.