Bladder Abnormalities

Congenital malformations of the bladder often occur without other abnormalities of the urogenital tract. They can cause infections, retention, incontinence and gastroesophageal reflux. All symptomatic malformations require surgical correction. Bladder A bladder diverticulum is a protrusion of the bladder mucosa by a defect of the bladder muscle. He predisposed to urinary tract infections and may require a reflux. It is usually found in young children in the clarification of recurrent urinary tract infections. The diagnosis is made by a voiding cystourethrogram. Sometimes the surgical removal of the diverticulum and a reconstruction of the bladder wall are indicated. Exstrophy Exstrophy When there is a lack of the closure along the center line from the navel to the perineum before, which leads to a Harnblasenmucosa continuity of the abdominal skin, and for the separation of the symphysis to epispadias doubled or genitals. The bladder is suprapubisch open and the urine dribbles rather than from the open bladder from the urethra. Despite the severe malformation normal renal function is preserved. The bubble can be reconstructed and eventually moved back into the basin. A vesicoureteral reflux is always present and must be eliminated depending on the case. A continuous urinary drainage may be necessary to treat a bladder reservoir that does not increase or if the sphincters are insufficient. The genitals have to be reconstructed. Mega cyst syndrome This syndrome is often a large, thin-walled bladder with no apparent obstruction of the bladder outlet develops in girls. The Mega cyst syndrome is not yet clear. The syndrome may present as primary myoneuraler defect, especially if in addition an intestinal obstruction (megazystisches microcolon, intestinal hypoplasia syndrome) is present. The symptoms are similar to those of a urinary tract infection and vesicoureteral reflux is frequent. Sonography is empty bladder may show a nearly normal-appearing upper urinary tract. When voiding cystourethrogram but you can see a reflux with a massive expansion of the upper urinary tract. A Ureterreimplantation can work well although some patients benefit from antibacterial prophylaxis, bladder training, intermittent catheterization, or a combination of treatments. Neurogenic bladder dysfunction Neurogenic bladder (s. Also neurogenic bladder dysfunction) is a bladder dysfunction caused by neurological disorders, including malformations of the spinal cord or CNS trauma or the consequences of pelvic surgery such. B. at sacrococcygeal teratoma or anal atresia. The bladder may be flaccid, spastic, or both. A sagging bladder is characterized by a bubble trap, a low discharge pressure and minimum contractions. Spastic bladder has a normal or low filling, an increased discharge pressure and involuntary contractions. Chronically elevated bladder pressures (> 40 cm H2O) can – even without infection or reflux – causing an increasing kidney damage. Symptoms include recurrent urinary tract infections, urinary retention and / or incontinence. The underlying neurological abnormality is usually recognizable easily. Usually, the residual urine is determined conducted a kidney ultrasound to detect any hydronephrosis and serum creatinine measured to assess renal function. Urodynamic tests are often necessary to confirm the diagnosis and to monitor the bladder pressure and function. Treatment goals are to reduce the risk of infection, maintaining adequate bladder pressure and volume, effective bladder emptying and achieving a socially compatible continence. The treatment includes drugs (eg. B. anticholinergics, prophylactic antibiotics), intermittent catheterization and / or surgical intervention (z. B. bubble expansion plastic appendicovesicostomy, botulinum toxin injections, neurostimulation). Children with neurogenic bladder often have a neurogenic bowel with constipation and fecal incontinence, which requires careful handling.

Health Life Media Team

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