Diffuse thickening of the bladder wall: The request could not be satisfied

30.04.201914.04.2021 by alexxlab

Содержание

Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

Abstract

Objective

Patients with interstitial cystitis (IC) and ketamine cystitis (KC) usually have similar symptoms, such as frequency, urgency, and bladder pain. In patients with IC, ulcer type and nonulcer type may have different cystoscopic features. This study investigated the clinical characteristics and bladder wall thickness (BWT) measured using computed tomography (CT) in patients with nonulcer IC, ulcer IC, and KC.

Materials and methods

The detailed history and bladder condition of patients with a clinical diagnosis of IC and KC were retrospectively analyzed. An abdominal to pelvis CT scan with/without contrast was performed in every patient. Ulcer type IC was noted in nine patients, nonulcer IC in seven patients, and KC in 13 patients. The bladder mass volume and BWT were measured. Bladder CT images of 10 patients with nonmetastatic renal cancer served as controls.

Results

The bladder wall was significantly thicker in all patients with ulcer type IC (8.91 ± 2.67 mm) and KC (10.7 ± 3.44 mm) than in those with nonulcer IC (2.89 ± 0.73 mm) or controls (2.65 ± 0.97 mm). Among KC patients, eight patients received augmentation enterocystoplasty. Moreover, the bladder wall was significantly thicker in patients who underwent augmentation enterocystoplasty (11.50 ± 3.21 mm) than those who did not (9.50 ± 3.81 mm). The bladder mass volume was increased in patients with KC who received augmentation enterocystoplasty (35.67 ± 11.19 mL) compared with those who did not (21.24 ± 7.25 mL). BWT significantly correlated with visual analogue scores for pain (R² = 0.484, p < 0.001), functional bladder capacity (R² = 0.31, p = 0.002), and maximum bladder capacity (R² = 0.469, p < 0.001) in overall patients.

Conclusion

There are obvious differences in bladder CT scans of patients with symptoms of bladder pain due to different etiology. Increased BWT was associated with increased pain scores and decreased bladder capacity in patients with KC and IC. BWT on a CT scan might be considered a marker for the severity of bladder inflammation.

Keywords

diagnosis

end-stage bladder disease

image study

pain

Citing articles

Stages, Symptoms, Treatment & Tests

Overview

Blue Light Technology in Bladder Cancer Therapy

What is bladder cancer?

The bladder, a hollow organ in the lower part of the abdomen, serves as a reservoir for urine until it is discharged out of the body through the urethra.

There are different types of bladder cancer. The cancer cell type can be transitional cell carcinoma, squamous cell carcinoma or adenocarcinoma—each named for the types of cells that line the wall of the bladder where the cancer originates.

Most bladder cancers (more than 90 percent) start from the transitional cells, which occupy the innermost lining of the bladder wall. The cancers, which originate in these cells lining the bladder can, in some instances, invade into the deeper layers of the bladder (called the lamina propria), the thick muscle layer of the bladder, or through the bladder wall into the fatty tissues that surround the bladder.
Squamous cells are thin flat cells that line the urethra and can form in the bladder after long bouts of bladder inflammation or irritation. Squamous cell carcinoma makes up about 5 percent of bladder cancers.
Adenocarcinoma is a very rare type of bladder cancer that begins in glandular (secretory) cells in the lining of the bladder. Only 1 percent to 2 percent of bladder cancers are adenocarcinoma.

What are the stages of bladder cancer?

Bladder cancer can be either early stage (confined to the lining of the bladder) or invasive (penetrating the bladder wall and possibly spreading to nearby organs or lymph nodes).

The stages range from TA (confined to the internal lining of the bladder) to IV (most invasive). In the earliest stages (TA, T1 or CIS), the cancer is confined to the lining of the bladder or in the connective tissue just below the lining, but has not invaded into the main muscle wall of the bladder.

Stages II to IV denote invasive cancer:

In Stage II, cancer has spread to the muscle wall of the bladder.
In Stage III, the cancer has spread to the fatty tissue outside the bladder muscle.
In Stage IV, the cancer has metastasized from the bladder to the lymph nodes or to other organs or bones.

A more sophisticated and preferred staging system is known as TNM, which stands for tumor, node involvement and metastases. In this system:

Invasive bladder tumors can range from T2 (spread to the main muscle wall below the lining) all the way to T4 (tumor spreads beyond the bladder to nearby organs or the pelvic side wall).
Lymph node involvement ranges from N0 (no cancer in lymph nodes) to N3 (cancer in many lymph nodes, or in one or more bulky lymph nodes larger than 5 cm).
M0 means that there is no metastasis outside of the pelvis. M1 means that it has metastasized outside of the pelvis.

Symptoms and Causes

What are the warning signs of bladder cancer?

Some symptoms of bladder cancer are also symptoms of other conditions, and should prompt a visit to your physician. Blood in the urine is the most important warning sign. Pain during urination, frequent urination or difficulty urinating are other symptoms.

Diagnosis and Tests

What tests will I have if my doctor suspects bladder cancer or another urinary problem?

Your doctor will want to analyze your urine (urinalysis) to determine if an infection could be a cause of your symptoms. A microscopic examination of the urine, called cytology, will look for cancer cells.

A cystoscopy is the main procedure to identify and diagnose bladder cancer. In this procedure, a lighted telescope (cystoscope) is inserted into your bladder from the urethra to view the inside of the bladder and, when done under anesthesia, take tissue samples (biopsy), which are later examined under a microscope for signs of cancer. When this procedure is done in the doctor’s office, local anesthesia gel is placed into the urethra prior to the procedure to minimize the discomfort.

If the diagnosis of bladder cancer is made, then the next step is to remove the tumor for detailed staging and diagnosis.

Transurethral resection (TURBT) is a procedure done under general or spinal anesthesia in the operating room. A telescope is inserted into the bladder and the tumor is removed by scraping it from the bladder wall (a portion of the bladder wall is removed with it), using a special cystoscope (called a resectoscope). This procedure is diagnostic as well as therapeutic.

This often can be done as an outpatient procedure, with patients discharged from hospital the same day. After removal, the tumor is analyzed by a pathologist, who will determine the type of tumor, the tumor grade (aggressiveness) and the depth of invasion. The purpose of the procedure is to remove the tumor and obtain important staging information (such as the tumor grade and depth of invasion).

For some patients with invasive cancer, a CT scan of the abdomen and pelvis might be the next step to determine if there is any spread of the disease outside of the bladder.

Magnetic resonance imaging, which uses a magnet, radio waves, and a computer to take detailed images, can also be done, and is helpful in planning additional treatment.

A chest X-ray may also be performed to detect if any cancer has spread to the lungs. At times, a bone scan may be performed to look for metastasis (spread) of the cancer to the bone. Most of these tests are used selectively, i.e., only in certain patients with related symptoms.

Once bladder cancer is diagnosed, staging of the disease is done using the tests described above. The stage of the disease will determine the treatment course.

Management and Treatment

What are the treatment options for bladder cancer?

There are four types of treatment for patients with bladder cancer. These include:

Sometimes, combinations of these treatments will be used.

Surgical options

Surgery is a common treatment option for bladder cancer. The type of surgery chosen will depend on the stage of the cancer.

Transurethral resection of the bladder is used most often for early stage disease (TA, T1, or CIS). It is done under general or spinal anesthesia. In this procedure, a special telescope called a resectoscope is inserted through the urethra into the bladder. The tumor is then trimmed away with the resectoscope, using a wire loop, and the raw surface of the bladder is then fulgurated (destroyed with an electric current).
Partial cystectomy is the removal of a section of the bladder. At times, it is used for a single tumor that invades the bladder wall in only one region of the bladder. This type of surgery retains most of the bladder. Chemotherapy or radiation therapy is often used in combination. Only a minority of patients will qualify for this bladder-sparing procedure.
Radical cystectomy is complete removal of the bladder. It is used for more extensive cancers and those that have spread beyond the bladder (or several early tumors over a large portion of the bladder).

This surgery is often done using a robot, which removes the bladder and any other surrounding organs. In men, this is the prostate and seminal vesicles. In women, the ovaries, uterus and a portion of the vagina may be removed along with the bladder.

Because the bladder is removed, a procedure called a urinary diversion must be done so that urine can exit the body. A pouch constructed of intestine may be made inside the body, or a leak-proof bag worn outside the body may be used to collect urine. The procedure typically requires a hospital stay of five to six days, give or take a few either way.

Chemotherapy

Chemotherapy refers to the use of any of a group of drugs whose main effect is either to kill or slow the reproduction of rapidly multiplying cells. Cancer cells absorb chemotherapy drugs faster than normal cells do (but all cells are exposed to the chemotherapy drug). Chemotherapy drugs are delivered intravenously (through a vein) or can be delivered intravesically (directly into the bladder through a catheter threaded through the ureter), depending on the stage of the cancer.

Some common chemotherapy drugs that are used for the treatment of bladder cancer include:

Methotrexate
Vinblastine
Doxorubicin
Cyclophosphamide
Paclitaxel
Carboplatin
Cisplatin
Ifosfamide
Gemcitabine

Many of these drugs are used in combinations.

Side effects can occur with chemotherapy, and their severity depends on the particular drug used and the ability of the patient to tolerate the drugs. Common side effects from chemotherapy include:

Chemotherapy can be used alone, but is often used with surgery or radiation therapy.

Intravesical therapy

Bladder cancer may be treated with intravesical (into the bladder through a tube inserted into the urethra) immunotherapy or chemotherapy.

Immunotherapy refers to using the body’s own immune system to attack the cancer cells. A vaccine called Bacillus Calmette-Guérin (BCG) is commonly used for this purpose in the intravesical treatment of stages Ta, T1, or carcinoma in situ (limited to the innermost lining) bladder cancers. In the procedure, a solution containing BCG is retained in the bladder for a few hours before being drained.

Intravesical BCG is usually given once a week for six weeks, but sometimes long-term maintenance therapy is needed. Bladder irritation, pain or burning during urination, and low-grade fever and chills are possible side effects of intravesical BCG.

Intravesical chemotherapy with mitomycin C is another treatment option. Because the chemotherapy is given directly into the bladder, other cells in the body aren’t exposed to the chemotherapy, which reduces the chances for side effects from the chemotherapy. It’s also often given as a single dose after a tumor has been removed via cystoscopy.

Radiation therapy

Radiation therapy damages the DNA of cancer cells by bombarding them with high-energy X-rays or other types of radiation. It may be an alternative to surgery or used in combination with surgery or chemotherapy. Radiation therapy can be delivered externally or internally.

In external radiation therapy, the radiation source is a machine outside the body that directs a focused beam of radiation at the tumor. With better imaging technologies in use today, computer-guided radiation delivered from several angles minimizes radiation exposure to surrounding tissues and organs, limiting damage to these tissues. Fatigue, swelling of soft tissues and skin irritation are common side effects of external radiation.

Internal radiation therapy is not often used for bladder cancer. In this type of treatment, a radioactive pellet is inserted into the bladder through the urethra or an incision in the lower abdomen. Internal radiation requires a hospital stay during the course of treatment, which can be several days, after which the pellet is removed.

Prevention

What are the risk factors for bladder cancer?

Some factors increase the risk of bladder cancer:

Cigarette smoking is the biggest risk factor; it more than doubles the risk. Pipe and cigar smoking and exposure to second-hand smoking may also increase one’s risk.
Prior radiation exposure is the next most common risk factor (e.g., as treatment for cervical cancer, prostate cancer or rectal cancer).
Certain chemotherapy drugs (e.g., cyclophosphamide) also increase the risk of bladder cancer.
Environmental exposures increase the risk of bladder cancer. People who work with chemicals, such as aromatic amines (chemicals used in dyes) are at risk. Extensive exposure to rubber, leather, some textiles, paint, and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
Infection with a parasite known as Schistosoma haematobium, which is more common in developing countries and the Middle East. (This organism is not found in the United States.)
People who have frequent infections of the bladder, bladder stones, or other diseases of the urinary tract, or who have chronic need for a catheter in the bladder, may be at higher risk of squamous cell carcinoma.
Patients with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.

Other risk factors include diets high in fried meats and animal fats, and older age. In addition, men have a three-fold higher risk than women.

Resources

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Lower Paxton woman’s bladder cancer shows importance of not ignoring urinary tract infections, other symptoms

Jenifer Donnelly.jpeg

Jenifer Donnelly had none of the classic risk factors for bladder cancer and she warns others not to ignore symptoms that don’t fit with the disease.

(Courtesy of the Donnelly family)

Tom Harbert, who died Dec. 1, battled invasive bladder cancer that he believed resulted from a medication he took for diabetes.

For more than a year, Jenifer Donnelly put up with the uncomfortable symptoms of a urinary tract infection that many women know all too well – urgency, frequency, burning. But when doctors looked further she received an unexpected diagnosis: Bladder cancer.

“No one in my family had bladder cancer. One of the first signs of it is blood in the urine and I never had that,” said the 55-year-old Lower Paxton Township woman who was diagnosed in March 2011.

When she sought help at a gastroenterologist who ordered a CT scan, it showed a thickened bladder wall. A cystoscopy procedure to look inside the bladder and take a biopsy found a low-grade bladder cancer that, luckily, had not penetrated the muscle wall.

The good news with bladder cancer is that 70 percent of newly-diagnosed bladder cancers are early stage and very treatable, according to Dr. Jongming Li, an oncologist with PinnacleHealth System.

About 75,000 Americans are diagnosed with bladder cancer annually and about 15,600 American die from it each year, according to the American Cancer Society. The majority of people diagnosed are older than age 55 and the average age at time of diagnosis is 73.

Former state legislator Mike Waugh, who was most recently the executive director of the Pennsylvania Farm Show Complex and Expo Center in Harrisburg, died in October after a long battle with bladder cancer.

The No. 1 risk factor for bladder cancer is smoking.

“Carcinogens from smoking get into the urine and can damage the lining of the bladder,” Li said “This is critical information to know. If you smoke, you are three times as likely to get bladder cancer.”

Men are three to four times more likely to develop bladder cancer and it’s the fourth leading cancer in men, but Dr. R. Scott Owens, urologist with Urology of Central PA, said his practice has been seeing increased numbers of younger people being diagnosed and more women, perhaps because more women are smoking.

Abnormal symptoms possible

Donnelly defies many things common among bladder cancer victims – she was younger than 55 when diagnosed; she’s a woman and she never smoked. Her parents, however, both smoked, which makes her wonder about the impact of second hand smoke. A graphic designer, she also has none of the chemical exposures linked to bladder cancer.

She was given an immunotherapy treatment called Bacillus Calmette-Guerin, or BCG therapy, an effective immunotherapy for treating early-stage bladder cancer.

The body’s immune system sees the BCG, a bacterium related to tuberculosis that is put directly into the bladder through a catheter, and attacks it and also kills the cancer cells, Owens said.

After several rounds of BCG, “I think my bladder just threw up its hands and said ‘I’m done,'” said Donnelly, who suffered with ongoing cystitis that had similar symptoms to her original ones even when her cancer was at bay from January 2012 to September 2014. She took steroids and antibiotics to manage it.

Then this fall, tests showed recurrence of a low-grade malignancy. She now takes a chemotherapy drug called docetaxel that is not supposed to irritate her bladder like some of the other chemotherapy drugs used for bladder cancer.

“I’m back to square one again, but it’s still non-invasive. It just wears on you a bit because it’s always there,” she said.

Invasive type less common

Unlike Donnelly, Tom Harbert unfortunately has the worst kind of bladder cancer – invasive into the bladder wall. The 51-year-old Hampden Township man passed away Dec. 1, surrounded by his family.

As in Donnelly’s case, Harbert’s symptoms were not classic for bladder cancer. He had abdominal cramps and gas pains that eventually became so severe that he was sent for a CT scan that revealed a tumor in his bladder that was already through the bladder wall.

His only option was to have his bladder removed. Rather than have chemotherapy before surgery, the bladder was removed first due to the aggressiveness of his cancer, he said. He woke up not with the internal neobladder made from intestine that he expected but with a urostomy pouch.

“When the doctor saw how invasive the cancer was, they didn’t want to wait for a neobladder to heal. They wanted me to start on chemo as quickly as I could,” Harbert said in November. The cancer had spread to his peritoneal area and his lymph nodes were visibly cancerous as well.

On strong pain medications and nearing death, Harbert wanted to be interviewed to warn other people not to ignore symptoms abnormal for bladder cancer.

Although he didn’t smoke and wasn’t around chemicals, Harbert was diabetic and had taken a drug called Actos for 10 years. It has been linked to bladder cancer, with a recent study suggesting that it more than doubles the risk of bladder cancer for people who take it more than a year.

“When you have a symptom, don’t sit on it,” Harbert said, adding it “hurt him a lot” to think that a drug that was supposed to help him may have claimed his life.

Harbert was told from the beginning that he had a very small chance of survival. He took chemotherapy and was cancer-free for nine months at one point. He was still plagued by constant urinary tract infections. Harbert said the loss of strength, hearing and cognitive abilities caused by the chemotherapy almost made him wish he had not taken it.

“It’s our goal as a family to do what we can because we don’t want anyone else to go through this,” said his wife of 22 years, Cindy Harbert. “There’s something about a bladder that people don’t like talking about it, but everyone’s got one and everyone goes to the bathroom. People have to understand bladder cancer exists and know the risk factors.”

The couple said they relied heavily on their faith to deal with Tom’s diagnosis.

“But we have two daughters who are 20 and 15 and they’re going to have a life without their dad,” Cindy Harbert said. “That’s been the most difficult thing to swallow.”

Study questions biopsy quality

A recent UCLA study published in the journal “Cancer” showed for the first time that when patients fail to get optimal biopsies, the disease is wrongly staged, meaning it is not recognized as being in an advanced a state. This leads to the treatment being less aggressive than warranted, increasing the chance the patient will die, the study found.

The two-year study looked at some 2,000 patients diagnosed with “non-invasive” bladder cancer and found that about half of them had biopsies that did not contain enough bladder wall muscle to accurately stage the cancer.

Doctors are cautious when taking biopsies because the bladder wall is thin and can be easily perforated, Li said.

“Oftentimes, we do see the urologist did not get enough tissue, but you can’t blame them. They don’t want to perforate,” he said. “They often go back for more tissue, but there is a limit on human abilities to do these things.”

Researchers said they hope their findings will empower patients to question their doctors about the quality of their biopsies and request repeat biopsies.

Owens said he thinks the study is actually more important for doctors than patients. He added that he doesn’t think wrongly-staged cancer is the reason why there isn’t a better survival rate for bladder cancer.

“I think [the study is] a good wake-up call to urologists to make sure we get muscle if there are signs that the cancer is invasive,” he said. “However, to take every patient and every tumor and say you have to have muscle taken is overaggressive because most are superficial. It’s a patient-by-patient analysis.”

(PDF) Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

transabdominal sonography and the corrected BWT did not differ

signiﬁcantly between women with IC and female controls.

In this

study, BWT was measured using CT scan and again, no difference

was found between the controls and IC patients, indicating that the

inﬂammation in IC, especially in the nonulcer type, is limited to the

urothelium and suburothelium. Five of the nine patients with ulcer

type IC had increased focal bladder wall thickening and perivesical

inﬁltration on CT scan, suggesting that bladder inﬂammation in-

volves the whole bladder wall and might cause severe bladder pain.

If focal thickening of the bladder wall is found in patients with ulcer

type IC, a partial cystectomy might be more effective than conser-

vative treatment.

KC was ﬁrst described by Shahani et al

in 2007. Ketamine

dependence leads to the development of lower urinary tract

symptoms that resemble IC/BPS. According to a nationwide survey

in the United Kingdom, 26.6% of regular ketamine users reported

experiencing at least one urinary symptom.

The symptoms were

signiﬁcantly related to both dose and frequency of ketamine use.

One histological bladder feature observed in KC is ulceration in the

presence of neutrophilic and lymphoplasma cell inﬁltration,

consistent with chronic inﬂammation.

7,25

Several studies have

shown that mast cells are crucial effector cells in the immune

response implicated in the pathogenesis of IC/BPS.

In KC, studies

have postulated that high concentrations of ketamine and its me-

tabolites in urine might have a direct toxic effect on urothelial cells,

inducing microvascular changes and neurogenic inﬂammation or

the evocation of an autoimmune response.

Chu et al

described reduced bladder compliance, detrusor

overactivity, and low bladder capacity in all of their patients with

KC, as well as hydronephrosis and impaired renal function in half of

them. Reduced compliance and low bladder capacity are commonly

seen in IC, except in hydronephrosis and impaired renal function. In

cystoscopy, KC patients show neovascularized areas and post-

hydrodistension hemorrhages, similar to those found in patients

diagnosed with ulcer type IC, but much more severe.

In this study,

we observed bilateral hydronephrosis in three KC patients, indi-

cating that the inﬂammation had involved the lower ureters

resulting in ureteral obstruction or vesicoureteral reﬂux. This

ﬁnding is also compatible with severe perivesical inﬂammatory

changes in patients with KC. The presence of a thickened bladder

wall, reduced bladder capacity, perivesical inﬁltration, and hydro-

nephrosis indicate the necessity for early surgical intervention to

provide rapid relief of intractable pain and an early return to society

for KC patients.

Patients with KC or IC have severe lower urinary tract symptoms

and bladder pain. Urodynamic study and cystoscopy without

anesthesia usually cause severe pain and intolerance to completion

of the studies. Therefore, these studies cannot demonstrate the

extent of the disease and are inconclusive in evaluating these pa-

tients. By contrast, bladder CT scan can provide clear images of both

the lower and upper urinary tract for evaluation. CT has been

considered the most useful imaging tool in evaluating patients with

KC, and demonstrates a small bladder, diffuse bladder wall thick-

ening, mucosal enhancement, and inﬂammatory changes in the

perivesical fat.

Measuring BWT on CT scan can not only identify a

pancystitis such as in KC, but can also provide evidence for early

surgical intervention.

The results of this study showed different ﬁndings in bladder CT

scans in patients presenting bladder pain from different diseases.

Because an increased BWT is associated with a higher VAS, reduced

FBC, and smaller MBC, the results suggest that bladder CT is a useful

investigative tool for evaluation of the severity of bladder inﬂam-

mation in patients with bladder pain. BWT might be used as a

predicting factor for early, unavoidable surgical intervention in

these patients.

Although BWT was increased in patients with ulcer type IC and

KC, factors that might induce thickening of the bladder wall should

be searched for, such as aging, bladder outlet obstruction, and

neurogenic bladder dysfunction. In this study, most of the patients

with KC were young and most of the patients with IC/BPS were

women. Neurogenic bladder dysfunction and bladder outlet

obstruction can be ruled out by videourodynamic study in the

diagnostic procedures. Nevertheless, the confounding factors of

increased BWT should be considered.

The main limitations of the present study were the small case

number and the difﬁculty in measuring the exact maximal bladder

volume during CT scan. Furthermore, the CT scan was performed

every 2.5 cm as one cut, which may have caused test errors in

measuring the exact bladder volume. Nevertheless, the diffuse

bladder wall thickening in KC bladders, focal bladder wall thick-

ening in ulcer type IC bladders, and increased perivesical inﬁltra-

tion in most KC bladders were are not affected by these potential

technical errors.

5. Conclusion

There are obvious differences in bladder CT scans of patients

with nonulcer IC, ulcer type IC, and KC. Bladder CT is useful for the

evaluation of the severity of bladder inﬂammation and differential

diagnosis in patients with KC and IC. BWT might also be a predictor

of identifying patients for surgical intervention such as AE in pa-

tients with KC.

Conﬂicts of interest

All contributing authors declare no conﬂicts of interest.

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S.-Y. Wu et al. / Urological Science xxx (2015) 1e6 5

Please cite this article in press as: Wu S-Y, et al., Increased bladder wall thickness is associated with severe symptoms and reduced bladder

capacity in patients with bladder pain syndrome, Urological Science (2015), http://dx. doi.org/10.1016/j.urols.2015.06.154

Comparison of Bladder Wall Thickening and Presence of Internal Echoes Within the Bladder for the Diagnosis of Cystitis in Infants | Iranian Journal of Pediatrics

Control group (N) consisted of 713 patients whose ultrasound examination was normal (no bladder wall thickening and no echoes in the lumen of bladder and no perivesical fluid). Among these 713 patients, 98 had pathological urinalysis results. The pathological urinalysis rate was 13.7%. In this group sensitivity was 0.597, and specificity was 0.723 for pathological urinalysis results.

Perivesical fluid group (P1) consisted of 43 patients whose ultrasound examination revealed only perivesical fluid without either bladder wall thickness or echoes in the lumen of bladder. Among these 43 patients, 8 had pathological urinalysis results. The pathological urinalysis rate was 18.6%. When compared with control group, pathological urinalysis rate was higher but it was not statistically significant. In this group sensitivity was 0.033, and specificity was 0.959 for pathological urinalysis results.

Bladder wall thickness group (P2) consisted of 170 patients whose ultrasound examination detected only thickened bladder wall (≥ 3.9 mm) without either perivesical fluid or echoes in the lumen of bladder. Among these 170 patients, 62 had pathological urinalysis results. The pathological urinalysis rate was 36.5%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group, sensitivity was 0.255 and specificity 0.873 for pathological urinalysis results.

The lumen group (P3) consisted of 116 patients whose ultrasound examination showed only echoes within the bladder lumen without either perivesical fluid or thickened bladder wall. Among these 116 patients, 48 had pathological urinalysis results. The pathological urinalysis rate was 41.4%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0. 05). In this group, sensitivity was 0.198 and specificity 0.920 for pathological urinalysis results.

Fluid or thickened wall or echoes group (P4) consisted of 319 patients whose ultrasound examination detected perivesical fluid or thickened bladder wall or echoes in the lumen of bladder. Among these 319 patients, 118 had pathological urinalysis results. The pathological urinalysis rate was 37.0%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group, sensitivity was 0.481 and specificity 0.764 for pathological urinalysis results.

Fluid and thickened wall group (P5) consisted of 11 patients whose ultrasound examination detected perivesical fluid and thickened bladder wall without echoes in the lumen of bladder (Figure 1). Among these 11 patients 5 had pathological urinalysis results. The pathological urinalysis rate was 45.5%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group, sensitivity was 0.021 and specificity 0.993 for pathological urinalysis results.

Figure 1.
Bladder wall thickening (5, 7 mm) and perivesical fluid (arrows) are seen

Fluid and echoes group (P6) consisted of 9 patients whose ultrasound examination detected perivesical fluid and echoes in the lumen of bladder without thickened wall of bladder (Figure 2). Among these 9 patients, 4 had pathological urinalysis results. The pathological urinalysis rate was 44.4%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group, sensitivity was 0.016 and specificity 0.994.

Figure 2.
Internal echoes within the bladder which has normal wall thickness (3.0 mm). Perivesical fluid is seen (arrows)

Thickened wall and echoes group (P7) consisted of 22 patients whose ultrasound examination detected thickened bladder wall and echoes in the lumen of bladder without perivesical fluid (Figure 3). Among these 22 patients, 12 had pathological urinalysis results. The pathological urinalysis rate was 54.5%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group sensitivity, was 0.049 and specificity 0.988 for pathological urinalysis results.

Figure 3.
Internal echoes in the lumen of bladder with thickened wall (4.5 mm)

Thickened wall and echoes and fluid group (P8) consisted of 10 patients whose ultrasound examination detected thickened bladder wall and echoes in the lumen of bladder and perivesical fluid (Figure 4). Among these 10 patients, 6 had pathological urinalysis results. The pathological urinalysis rate was 60.0%. When compared with control group (N) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). In this group sensitivity was 0.025 and specificity 0.995 for pathological urinalysis results. Statistical analysis results of all groups are detailed in Table 1.

Figure 4.
Internal echoes in the lumen of bladder with thickened wall (4.1 mm). Also perivesical fluid is seen (arrows)Table 1.
The Detailed Statistical Results of All Groups

Finding	N	P1	P2	P3	P4	P5	P6	P7	P8	Total
	Control Group	Perivesical Fluid	Thickened Bladder Wall	Echoes in the Lumen	Fluid or Thickened Wall or Echoes In the Lumen	Perivesical Fluid and Thickened Bladder Wall	Perivesical Fluid and Echoes in the Lumen	Thickened Bladder Wall and Echoes in the Lumen	Thickened Wall and Echoes in Lumen and Perivesical Fluid
Patients	713	43	170	116	319	11	9	22	10	1094
Pathological urinalysis	98	8	62	48	118	5	4	12	6	253
Pathological urinalysis ratio, %	13. 7	18.6	36.5	41.4	37.0	45.5	44.4	54.5	60.0	23.1
Sensitivity	0.597	0.033	0.255	0.198	0.486	0.021	0.016	0.049	0.025
Specificity	0.723	0.959	0.873	0.920	0.764	0.993	0.994	0.988	0.995
False negative rate	0.403	0.967	0.745	0.802	0.514	0.979	0.984	0.951	0.975
False positive rate	0.277	0.041	0.127	0.0080	0.236	0.007	0.006	0.012	0.005
Accuracy	0.695	0.753	0.736	0.760	0.702	0.777	0.777	0.780	0.780
Positive predictive value	0.381	0.186	0.365	0.414	0.370	0.455	0.444	0.545	0.600
Negative predictive value	0.863	0.776	0.804	0.801	0.839	0.780	0.780	0.785	0.781
Positive hjlikehood ratio	2.152	0.800	2.010	2.472	2.056	2.918	2.802	4.202	5.253
Negative likehood ratio	0.558	1.009	0.853	0.872	0.673	0.986	0.989	0.962	0.980

Also patients in thickened wall group (P3) were classified to 3 subgroups according to their bladder wall thicknesses. The first subgroup (SG1) consisted of 92 patients whose ultrasound examination detected a bladder wall thickness between 3.9 and 4.9 mm. Among these 92 patients 31 had pathological urinalysis results. The pathological urinalysis rate was 33.6%. When compared with control group (N) (13.7%) pathological urinalysis rate was significantly higher (P < 0.05).

The second subgroup (SG2) consisted of 54 patients whose ultrasound examination detected a bladder wall thickness between 5.0 and 6.0 mm. Among these 54 patients, 19 had pathological urinalysis results. The pathological urinalysis rate was 35.1%.When compared with control group (N) (13.7%) pathological urinalysis rate was significantly higher (P < 0.05). However when compared with subgroup 1, pathological urinalysis rate was higher but this difference was not statistically significant (P > 0.05).

The third subgroup (SG3) consisted of 24 patients whose ultrasound examination detected a bladder wall thickness > 6 mm (Figure 5). Among these 24 patients, 12 had pathological urinalysis results. The pathological urinalysis rate was 50.0%.When compared with control group (N) (13.7%) pathological urinalysis rate was higher and this difference was statistically significant (P < 0.05). Also when compared with both subgroups 1 and 2, pathological urinalysis rate of subgroup 3 was higher and these differences were statistically significant (P < 0.05 for both). Pathological urinalysis rates of subgroups are summarized in Table 2.

Figure 5.
Markedly thickened bladder wall (9.1 mm) (subgroup 3) is seenTable 2.
Pathological Urinalysis of Three Subgroups of Group P3 (Thickened Bladder Wall Group)

	Bladder Wall Thickness 3.9 – 4.9 mm (SG1)	Bladder Wall Thickness 5.0 – 6.0 mm (SG2)	Bladder Wall Thickness > 6 mm (SG3)
Pathological urinalysis numbers	31	19	12
Total cases number	n: 92	n: 54	n: 24
Pathological urinalysis rate	0.336	0.351	0.500

Also we compared the pathological urinalysis rates of males and females for each group. In all the groups pathological urinalysis rates of females was found to be higher than rates of males. The pathological urinalysis results of males and females are documented in Table 3.

Table 3.
Comparision of Pathological Urinalysis Rates of Male and Female Patients for Each Groups

	N	P1	P2	P3	P4	P5	P6	P7	P8
	Control	Perivesical fluid	Thickened bladder wall	Echoes in the lumen	Fluid or thickened wall or echoes in the lumen	Perivesical fluid and thickened bladder wall	Perivesical fluid and echoes in the lumen	Thickened bladder wall and echoes in the lumen	Thickened wall and echoes in lumen and periveical fluid
Pathological male urinalysis	23	2	13	13	28	1	1	3	2
Total male patients	371	12	75	39	126	4	4	8	4
Pathological male urinalysis rate, %	6.2	16.7	17.3	33.3	22.2	25.0	25.0	37.5	50.0
Pathological female urinalysis	75	6	49	35	90	4	3	9	4
Total female patients	342	31	95	77	193	7	5	14	6
Pathological female urinalysis rate, %	21.9	19.4	51.6	45.4	46.6	54.5	60.0	64.3	66.7

90,000 Bladder wall hypertrophy: types and causes and treatment

This condition leads to impaired urinary function. With a thickening of the bladder walls, the causes and treatment are determined based on the results obtained during the ultrasound examination of the organ and other studies.

Types of bladder wall hypertrophy

If obstacles appear in the path of urine, this process is disrupted. In this case, the musculature of the organ continues to receive signals from the brain, as a result of which the muscles begin to contract vigorously.Constantly tension of muscle fibers provokes diffuse changes in local tissues, because of this, hypertrophy develops.

Similar violations occur against the background of narrowing of the urethra, the development of diverticula, neoplasms. Often, a diffuse form of hypertrophy, in which most of the area of the bladder walls is thickened, occurs against the background of an inflammatory process caused by an organ infection.

In some cases, these and other reasons provoke changes in individual tissues.This is how a local type of hypertrophy develops, in which the walls of the bladder thicken in a small area.

Such disorders provoke papillomas, polyps, calculi (stones), helminthic invasion (mainly schistosomiasis). Due to the influence of these factors, an uneven thickening of the walls occurs. Local damage to the tissues of the bladder does not cause severe symptoms for a long time and is discovered by chance during an organ examination.

Hypertrophy is not an independent disease.The thickening of the walls of the bladder is always provoked by third-party factors, including infectious pathologies or tumor processes both in the bladder and in neighboring organs.

Causes of pathology

Despite the fact that the development of both forms of hypertrophy is based on the same mechanisms, the effect of various factors leads to a thickening of the walls of the bladder. The first type of pathology develops against the background:

Renal enlargement (known as hydronephrosis).Pathology is congenital or acquired.
Inflammation of diverticula (saccular protrusions). Urine accumulates in these pathological formations, as a result of which the organ is always emptied in two stages. First, the fluid is removed from the main cavity, and then from the diverticulum.
Ureterohydronephrosis, which is the cause of the development of a neurogenic bladder. This disease occurs mainly in the first years of life.
Urolithiasis. Due to the accumulation of calculi, urine diversion is disrupted, due to which the walls of the organ hypertrophy.Similar changes occur with tumors of the bladder and cervical stenosis, in which the opening of the urethra narrows.
Urethritis and cystitis. Both diseases occur due to infection of the organs of the urinary system. The bacterial microflora causes tissue inflammation, resulting in edema. This leads to a narrowing of the urinary tract, impaired outflow of urine and, as a result, hypertrophy of the bladder walls.
Infections and inflammation trigger a compensatory mechanism.That is, under the influence of these factors, the body stimulates cell division. Because of this, a thickening of the bladder occurs, since the muscles of the organ are under increased stress.

Features of the local form

The local form of hypertrophy develops under the influence of the following reasons:

abnormal structure of the bladder;

90,025 injuries;

tumors and other neoplasms;
tuberculosis;
schistosomiasis (one of the varieties of worm infestation)

90,025 congenital pathologies.

In the female body, hypertrophy develops mainly due to infections and hyperplasia of the uterus, in which the tissues of the mucous membrane grow. Moreover, this category of patients is more often faced with pathologies of the genitourinary system, which is explained by the peculiarities of the structure of the small pelvis.

The urethra is shorter in women than in men. In addition, the canal is located in the immediate vicinity of the vaginal mucosa, where the risk of developing pathogenic microorganisms is higher. A decrease in immunity promotes the activation of bacteria, which quickly penetrate into the urethra. If left untreated, the infection causes a thickening of the bladder wall in women.

The second reason (endometrial growth) is due to natural processes. Every month, the tissues of the uterus grow due to the release of the egg. If conception does not occur, the remainder of the overgrown mucous membrane is excreted from the body during menstruation. But in some cases, the mucous membrane grows, the uterus increases in size and begins to squeeze adjacent organs.

Manifestations

increase in the volume of excreted urine both during the day and at night;
pain syndrome in the perineal region;
feeling of incomplete emptying;
spontaneous excretion of urine.

The presence of a lump in the bladder in women provokes sexual dysfunction. Also, with hyperplasia, the urine pressure decreases. To empty the bladder, the patient needs to make an effort (push). Moreover, this process ends with a drop of urine.

In women with hyperplasia, the menstrual cycle is often disrupted, and menstruation is accompanied by profuse bleeding or disappear for six months or more (this condition is known as amenorrhea). These phenomena occur due to hormonal imbalance, which leads to diseases of the genitourinary system.

Diagnostics

If hypertrophy is suspected, a urinalysis is ordered. In the case of inflammation of the bladder tissue, the results of this test will show an increased level of leukocytes in urine.Also, through the analysis, the type of bacterial microflora that caused the inflammatory process is determined.

Ultrasound helps to confirm the assumption that the bladder tissue is thickened. This hardware technique allows you to assess the true size of the organ and identify neoplasms that caused diffuse changes.

Treatment of thickening of the bladder wall

If the disease is caused by a bacterial infection, antibiotics are prescribed. It is necessary to treat hypertrophy with drugs that can suppress the activity of various types of pathogenic microorganisms.

In addition to antibacterial drugs, for such disorders, non-steroidal anti-inflammatory drugs are used to stop the inflammatory process and reduce its manifestations. At the same time, antispasmodics are used, which normalize the excretion of urine.

In oncological processes, complex treatment is used, within the framework of which a course of chemotherapy and surgery are carried out. Radiation therapy is prescribed if necessary.

Prostatitis is treated in a comprehensive manner.Moreover, this disease requires a correction of the patient’s lifestyle. With inflammation of the prostate gland, antibacterial drugs, antispasmodics and physiotherapy are indicated. The patient with prostatitis is transferred to a dietary diet.

If hypertrophy occurs against the background of hormonal disorders, hormonal drugs are prescribed to eliminate the dysfunction of the endocrine system.

In addition to medical and surgical treatment, traditional medicine is used. In this case, a doctor’s consultation is necessary.A variety of infusions and decoctions are used to restore the affected tissues.

Using celandine and chamomile, you can suppress the activity of bacterial microflora, enhance the effect of antibiotics. These funds can be used both for internal use and for treating the organs of the genitourinary system. Beet juice stimulates urine excretion, and aloe prevents re-infection of the body and strengthens the immune system.

With hypertrophy, a complex of gymnastic exercises is often prescribed that strengthen muscle tissue and tone the prostate gland or organs of the reproductive system.

Prevention

It is also important to adhere to the rules of personal hygiene, not to overcool and promptly seek help in case of violations of the genitourinary system.

Thickening of the walls of the bladder: causes, treatment of women, men and children

There are many diseases in which the bladder wall thickens. Such hypertrophy of the walls of the organ is the main symptom in the diagnosis of diseases of the genitourinary system.

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The diagnosis of such diseases is difficult, but if you use ultrasound, the result can be obtained immediately for all patients, even for children.If an incorrect drug treatment regimen is not detected or prescribed in a timely manner, the disease turns into pathology, since most often the thickening of the bladder wall appears due to inflammation from infectious diseases.

The process when the walls are compacted can be diffuse or local. Consider the main indicators of the disease in which there is a thickening of the walls of the bladder, the causes, treatment and consequences of pathology

Why does the bladder hardening occur?

Diffuse bladder thickening occurs in infectious diseases leading to dysfunction of the urinary system.This increases the load on the walls of the organ. They have nerve endings that send a signal of fullness to the central nervous system.

By the body, this urge is deciphered as the need to empty, because of this, the muscle layers in the organ contract and urine leaves the body through the urinary tract. With dysfunction, the bladder is unable to push out the accumulated urine, so the walls gradually thicken.

Main symptoms

Urolithiasis, leading to disorders of the genitourinary system.With a significant size of the stone, it blocks the pathways for urine output, accumulation of fluid and an increase in internal pressure occurs;
Neoplasm in the neck of the bladder, the narrowest point at which the urine outlet is blocked. Thickening of the walls of the bladder in men occurs due to the pathology of the prostate, which is accompanied by impaired deurination due to the pressure of the enlarged gland on the urethra. That is why male patients with malfunctions of the bladder need to do an examination of the prostate gland;
Features of the anatomical structure of the genitourinary system in women, consisting in a short and wide enough urethra, located close to the anus and vagina.The walls of the bladder thicken due to vulnerability to inflammatory diseases, and cystitis can also be the cause. A similar disease can occur in men, but much less often;
Narrowing at the junction of the urinary tract and bladder, called cervical stenosis. Stenosis can be either acquired due to previous diseases or congenital;
Lumps in the bladder are often caused by urethritis, in which they become inflamed in the urinary tract;
The presence of a diverticulum, a sac-like depression in the wall of the urethral canal.It is also possible to locate it in the cervical region, which interferes with natural urination.

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Local pathology

Local type compaction differs from diffuse pathology in its spread not along all the walls of the organs, but in a specific area of its tissues.

With thickening of the walls of this type, there are practically no symptoms, which significantly complicates the diagnosis.

Only regular planned examination can help the situation, since the pathology of the local type is hereditary or acquired in nature.

The most common causes are as follows:

Peculiarities of the anatomical structure of the patient’s bladder;

90,025 polyps, papillomas, neoplasms, both malignant and benign, as well as stones;

dysfunction of the bladder of nervous etiology;
condition of schistosomiasis due to parasite infestation;
tuberculosis of the bladder;
injury and damage to internal organs;

90,025 in women with inflammatory processes, as well as irregular sexual activity or infection of the external genital organs.

Hyperplasia

Hyperplasia is a pathology accompanied by an increase in the number of cells in the membrane of the organ. This leads to an increased volume of the bladder or a neoplasm in it. For women and men, hypoplasia differs in different types.

In the prostate gland or with prostate adenoma in men, the work of the urinary system is disrupted, as a rule, after 40 years. This is caused by benign formations in the walls of the prostate. They resemble nodules that, with an increase in size, pinch the opening of the urethra.There can be several such formations.

In women, hyperplasia is associated with the endometrium in the uterine lining. With the proliferation of the endometrium, which normally occurs monthly, the uterus prepares to receive a fertilized egg. In the absence of conception, excess membranes go away during menstruation.

Symptoms of hyperplasia

Thickening of the walls of the bladder with hyperplasia in men is characterized by the following symptoms:

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1	Frequent deurination and polyuria and frequent urination
2	nocturia, in which a significant amount of fluid is released at night, significantly exceeding the daytime
3	feeling of incomplete urination and not emptying the bladder
4	urination in the form of drops at the end of deurination
5	Sexual Disorders
6	Intermittent stream of urine with weak pressure and the need to push.Painful sensations are also possible

In women, symptoms include an irregular menstrual cycle, acute pain and massive bleeding. In some cases, amenorrhea occurs when menstruation is absent for six months or more.

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These symptoms are recognized as hormonal imbalances, leading to a variety of diseases from polycystic ovary disease to infertility. All of these pathologies are characterized by thickening in the walls of the bladder.

How to identify a thickened bladder wall?

The beginning of diagnosis with an increase in the walls of the bladder begins with the collection of the patient’s anamnesis, after which additional studies are prescribed.

The most effective and informative is the ultrasound of the bladder, which is performed on an organ filled with fluid.

Only in this state of his can the doctor see changes in the thickness of the walls and signs of chronic diseases.

To find out the nuances, it is necessary to undergo an X-ray examination, which will reveal the degree of damage to the walls.You can also use cystoscopy, which examines the organ from the inside, showing uneven surfaces in the mucosa, both front and back. With cystoscopy, it is often possible to determine the presence of a tumor and the extent of its spread, as well as other abnormalities.

Treatment

In case of thickening of the walls of the bladder, it is necessary to consult a gastroenterologist and strictly follow his recommendations. The course of treatment lasts about 2 weeks, its scheme is aimed at removing inflammatory processes and disinfecting the organ.

It is also necessary to restore the initial parameters of the bladder wall. For this, the cause of the pathology is established, then a drug treatment regimen is prescribed with antibiotics, which are fed to the affected organ in high concentration.

Antibiotics are often accompanied by treatment with antibacterial drugs, which include Cholenzym, Allochol, Nicadim and Oxafenamide. Papaverine, Nitrite, Amisil, Atropine and Euphyllin are just as effective. If a tumor is found on examination, it is necessary to carry out chemotherapy and surgery

In the treatment of male prostatitis, therapy should be comprehensive, including physiotherapy, prostate massage and correction of immunity.In women, hyperplasia is treated with drugs containing hormonal substances, but if there is endometriosis or its relapses, surgery is necessary. For each patient, treatment is prescribed individually, based on the history and complexity of the disease.

Traditional medicine

Traditional medicine with its plant substances can not only remove the seal of the walls in the organ, but also get rid of neoplasms and tumors with regular intake of phyto-drugs.Each of the recipes is useful, but you must first check the body for allergic reactions to plants.

Patients are recommended herbal teas from dandelion leaves, toadflax, mint, flowers and leaves of tansy, cinquefoil roots. Also useful will be tinctures of carrots, black radish, beets, aloe, vodka and honey.

The most popular folk remedy is ordinary millet, half a glass of which is washed and left in half a liter of clean hot water. After 15-15 minutes, shake the infusion and drink 150 ml up to five times a day for 15 days.Taking this remedy will reduce pain and cleanse the urinary ducts. Porridge made from this grain is also useful in any form.

Corn silk in the form of a decoction can relieve inflammation and reduce the intensity of pain. To do this, pour a tablespoon of the dry mixture with cold water, at least three glasses.

It is better to take clean water, but not from the tap. The broth is cooked for half an hour on a small window. Three times a day before meals, you need to take the resulting liquid in its pure form.

It is forbidden to take this remedy for thrombophlebitis or varicose veins.

More on the topic: Features of the psychosomatics of the bladder

Everyone’s favorite pumpkin seeds are ground in a blender. The resulting cake must be boiled for three minutes, insisted for a couple of hours and drunk two liters a day. It is not necessary to filter, it is important to drink with the sediment.

When cooking, carrot tops are often left, especially if the house has a personal plot and vegetable garden. A handful of carrot tops and half a liter of boiling water are infused for about an hour.Further, the tincture is taken 4-5 times a day before meals.

Dill, which is effective both in the form of herbs and dried seeds, successfully fights against many diseases of the genitourinary sphere. A tablespoon of seeds and a glass of cold water are placed on the stove and boiled for several minutes. The broth is filtered and drunk 50 ml three or four times a day.

NATURAL ANTIBIOTIC ELIMINATES ALL BLADDER AND KIDNEY INFECTIONS

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Thickening of the bladder wall – Healthy family

A fairly large number of diseases are known, accompanied by a thickening of the walls of the urea.This is one of the most important signs for detecting violations in the performance of the urinary system.

It is difficult to determine such changes, but with the help of an ultrasound examination it is quite possible.

Untimely examinations or irregularities in treatment courses can cause the appearance of pathologies, because the thickening of the walls of the bladder is often associated with previous infections or the appearance of new diseases.

Varieties of pathology

By the type of thickening, diffuse and local diseases are distinguished.

Diffuse type of disease

This thickening of the walls can cause inflammation or a sudden increase in muscle stress.

The urinary tract is a hollow organ of muscles. It is designed to accumulate and retain urine in itself. The process of urine withdrawal is designed in such a way that from filling the bladder, its nerve cells begin to experience irritation.

The signal sent to the brain returns as a command to the beginning of urine drainage, after which the muscle tissue begins to contract.

If the urine outlet is blocked, then the muscles will make great efforts, trying to push urine even through the obstacle that appears. Prolonged and numerous contractions cause an increase in muscle mass, from which the walls thicken.

Having identified such changes, the doctor must perform all studies in order to timely discern the likely pathology and prescribe the correct treatment.

Wall thickening may appear due to cystitis. Having penetrated into the urinary tract, the infection will affect the mucous membrane, provoke changes, which will cause the appearance of thickenings.

Local type of disease

It is not distributed over the entire surface of the walls, but only in small areas. One of the reasons may be heredity associated with some features of the structure of the genital organs.

It happens that local pathology is acquired in the process of life. Corrections can be made by trauma to the bladder, provoking the appearance of hematomas preceding thickening.

Formations of a malignant and benign nature, papillomas, polyps, detected by ultrasound of the bladder, are manifested as hyperechoic formations.An ordinary stone can look in the same form.

The walls of the bladder can also become hardened due to tuberculosis. True, external signs in this case do not appear, and to identify pathology, the doctor will need a diagnostic examination.

The main causes of pathology

There are nerve endings in the bladder that are triggered when it is full and send signals to the brain. The result of decoding them is very simple – it became necessary to empty the urine.

Ultimately, the muscles contract, urine is directed outward along the urethra. If the bladder does not work properly, then it is not able to “push out” the accumulated volume of fluid, which causes a gradual thickening of the muscle layers.

One of the reasons for this change can be a large stone blocking the ureter.

There are some other reasons for the thickening of the bladder wall:

New lesions in the narrow area of the neck , which can also block the urine channel.
Narrowing of the opening , which connects the bladder with the discharge channel, causes diffuse pathological manifestations. This is a stenosis, which is congenital or acquired as a result of past diseases.
Urethritis – an inflammatory process of a chronic nature in the urinary tract.
Diverticulum. This is a saccular depression in the walls of the urethra, located near the neck and interfering with the normal flow of urine.

Features of the seal

This disease also occurs in children.It is very important here to identify the symptoms in time, because children are often unable to explain what ultimately bothers them. Note that the child may not even feel discomfort.

It is important to immediately determine the diagnosis and understand whether the defect is congenital or acquired due to a bladder disease.
For small patients, the formation of suspension in most cases is not a pathology, and in order to make a diagnosis, a thorough examination will have to be organized.
The age category of the patient is also considered important – this will determine the volume of fluid in the bladder, which is a normal phenomenon.
Women have an anatomical feature – the urethra is wide and small in length, located quite close to the anus and vulva.

The walls of the urea can become thickened due to a tendency to inflammation of the ureter – the so-called cystitis.

The disease is inherent in men, but among them it is very rare.Here the main reason may be the pathology of the prostate.

It is accompanied by all dysfunction of urine emission, which is created due to pressure on the urethra by an enlarged gland. For this reason, men who have identified the first signs of a malfunction of the bladder should examine the prostate gland.

Clinical manifestations of the disease

The first sign is the increased frequency of visits to the toilet.

If we talk about men, they will experience frequent urge to pass urine.During the day, the amount of emission will increase, at night, urine will be diverted abundantly.

At the same time, there is a constant feeling that the emptying has not taken place in full. The pressure will be weak, intermittent, strenuous straining will be required, accompanied by pain symptoms. The process will end with droplet emission.

For women, the main symptom is menstrual irregularities, severe bleeding, acute pain. Amenorrhea is possible – when periods are absent for six or more months.

These symptoms are signs of hormonal disorders, entail various diseases, after which there is a thickening in the urinary tract.

The disease is not the main one, it is considered a clinical manifestation, so doctors have to identify real pathologies in order to prescribe the correct treatment course.

Research is carried out using ultrasound. Before that, the patient needs to drink a lot of liquid so that the water fills the entire volume of the organ.

Performing the examination, the doctor will establish all the formations, their localization, the degree of risk. In addition, the size of the urea will be revealed, its ability to maintain the volume of urine will be determined. In order to diagnose the thickening of its walls, you need to have an idea of \ u200b \ u200bthe thickness rate. Normal thickness is 3-5mm. The rate of urine flow is 14 cm per second.

How is pathology therapy carried out?

Quite often, doctors prescribe Allochol for the treatment of thickening of the walls of the bladder.The treatment course lasts up to fifteen days. It is aimed at disinfecting and eliminating inflammatory processes, giving the walls a normal size.

In cases of exacerbations, drugs are prescribed against microbes and parasites – Nikodim, Holenzim, Amisil and others. If a tumor is detected, chemotherapy or surgery is performed.

As folk remedies, you can use mint tea, dandelion infusion, celandine. Vodka tinctures made from beet, carrot, black radish, aloe, honey juices help a lot.

Preventive measures

It is recommended to adhere to special diets that normalize metabolism, observe hygiene requirements, prevent hypothermia, play sports, and treat inflammatory diseases in time.

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Thickening of the walls of the bladder: what is it, symptoms, causes, treatment, prevention

Thickening of the walls of the bladder is a pathological condition that is often diagnosed.Hypertrophy develops in various diseases, is often asymptomatic, but can lead to serious complications. Therefore, it is important to know about the reasons for its appearance.

What is

The walls of the bladder are thickened most often in women due to anatomical features. The wide and short urethra is located close to the anus and vulva. Often, hypertrophy occurs with cystitis, when an inflammatory process develops in the ureter.

In men, pathology is extremely rare.Almost always in this case, diseases of the prostate gland lead to thickening. The enlargement of the prostate disrupts the process of urination, the inflamed organ presses excessively on the narrow and long urethra. All this leads to bladder disorders.

Classification

According to the type of development of hypertrophy, pathology is divided into diffuse and local types. In the first case, the thickening of the bladder wall often leads to inflammatory processes, excessive stress on the muscles.

When the outflow of urine is blocked, the muscle tissues are overstrained, trying to push the urine.Multiple contractions over a long period of time increase muscle mass, which causes the walls to thicken.

With the local type, hypertrophy is detected only in small areas of the surface. The main reason for this process is considered to be a genetic predisposition.

Often, a local disease becomes already acquired after mechanical damage to the bladder. Tuberculosis can also lead to this type of hypertrophy, as a result of which external signs will be absent, therefore, careful diagnosis will be required.

Reasons

Thickening of the muscle layers of the organ occurs for the following reasons:

Due to genetic predisposition , in which children suffer from the disease.
Due to the presence of inflammatory processes of an infectious nature – cystitis, urethritis. Even after therapy, the formed seal does not disappear, and after a relapse, the problem is only aggravated. Due to the anatomical features of the structure of the urethra, women are more likely to suffer from inflammation.
With an excessive activity of wall muscles. This condition occurs in the presence of urolithiasis, when the urethra is partially blocked, the bladder contracts, trying to push the urine. In men, hyperplasia occurs due to inflammation, enlargement of the prostate gland.
Due to diverticulum. A saccular depression in the urethra is located near the cervix and prevents the normal outflow of urine.

Another disease is formed with benign or malignant tumors, polyps, papillomas, tuberculosis of the bladder, violation of innervation, when nerves are clamped, roots in the spinal column.Mechanical damage to the organ, urethra, parasitic infections also provoke the development of hyperplasia.

Symptoms

Frequent urination with cuts, pain in the lower abdomen is the main sign of urolithiasis, inflammation, the presence of a malignant formation, as a result of which the walls of the bladder thicken. At the same time, urine will be released abundantly at night, all the time there is a feeling of incomplete emptying of the organ.

Urination with hypertrophy is weak, intermittent, the patient needs to constantly strain to push the drops through the obstacle.In women, the menstrual cycle is disturbed, profuse bleeding occurs, and acute pain syndrome appears.

Amenorrhea often appears when there is a long delay in menstruation. Another symptom of wall thickening is hematuria, in which urine is excreted along with blood impurities.

Diagnostics

If there is a suspicion of hypertrophy of the bladder walls, it is necessary to pass a general urine test, the results of which will differ from normal values.An increase in the level of leukocytes, the appearance of hematuria indicates an inflammatory process, the penetration of infection.

If clinical manifestations are present, and the results of laboratory studies do not show any abnormalities, then it is necessary to undergo instrumental diagnostics. For this, an ultrasound examination of the organ is used.

Thanks to this method, the size of the bladder, the thickness of the walls, the location of the hypertrophied area are established, various neoplasms, injuries, hematomas, calculi are detected.Before an ultrasound scan, it is imperative to drink 0.5 liters of liquid, since the examined organ must be completely filled.

Treatment

The choice of therapy depends on the cause of the hardening of the walls of the organ. If the thickening was caused by an infectious disease, an inflammatory process, then antibacterial drugs, non-steroidal anti-inflammatory drugs, antispasmodics are prescribed.

When hypertrophy occurs due to a genetic predisposition or mechanical damage, surgical intervention is required.With urolithiasis, it is necessary to eliminate calculi that block the outflow of urine.

Minor formations are eliminated by antispasmodics, when they come out on their own, or by crushing with ultrasonic waves. Large stones are removed by surgery.

If the thickening is caused by a malignant neoplasm, then complex therapy is required, including chemotherapy, radiation treatment, and surgery. In case of prostatitis, prostatic hyperplasia, it is first important to eliminate the primary disease, and then start healing the bladder.

In this case, antibacterial agents, prostate massage, physiotherapy manipulations are prescribed, bad habits are excluded.

Complications

Complications depend on the cause of the hypertrophy of the bladder walls. If the thickening has arisen due to infectious cystitis, urethritis, due to which the inflammatory process has developed, then it is important to eliminate the pathology quickly.

Otherwise, the acute form, in the absence of timely therapy, will flow into the chronic stage, which will significantly aggravate the situation.Chronic cystitis is characterized by frequent exacerbations, after which the walls of the organ will be thicker and thicker. As it thickens, clinical manifestations will become more pronounced, and the quality of life will noticeably deteriorate.

If the problem is caused by mechanical injury, then it is enough to protect the genitourinary system from further damage. The prostate gland and the cervix often suffer from malignant tumors, which also cause bladder hypertrophy.

Cancer tumors progress rapidly, metastasize, often end in death, so it is important to start treatment in a timely manner.

Forecast

The prognosis depends on the severity of the pathological process that caused its cause. In the presence of a malignant formation, the prognosis is poor, since the cancer is rapidly progressing.

In some cases, it is possible to eliminate hypertrophy only with the help of surgical intervention. This is especially true for advanced cystitis, so inflammation must be eliminated in the early stages.

If you consult a doctor on time, start adequate therapy in a timely manner, then the prognosis is favorable.In case of urolithiasis, ultrasound is used, with the help of which calculi are effectively crushed and removed, causing the walls of the bladder to thicken.

Prevention

To protect against the pathological process, it is necessary to undergo a prophylactic ultrasound examination of the abdominal cavity and pelvic organs annually in order to identify the problem at the initial stage. Timely treatment of cystitis will get rid of the infection, prevent the transition of the disease to a chronic form.

In addition, it is important to avoid hypothermia. Men must have their prostate gland examined by a urologist several times a year. This is especially true for people with harmful, sedentary, standing work. Timely elimination of pathologies of the prostate will protect against various serious problems.

Thickening of the bladder wall occurs for many reasons – from mechanical damage and genetic predisposition to the presence of a malignant formation. If the factor is eliminated in time – to treat cystitis, urethritis, to eliminate tumors, growths, calculi, then the bladder restores its functionality.

Thickening of the walls of the bladder

Some people are faced with diseases of the genitourinary system, due to changes in its organs. One of them is the thickening of the bladder walls in women and men, as well as children. In the article we will discuss why this condition is dangerous.

In case of problems with the urinary system, the first thing many go for an ultrasound scan. And just with such a study, a thickening of the bladder wall in men and women becomes noticeable.Often, such an anomaly indicates that some kind of infection was previously transferred.

Changes in the bladder are different. Today, there are two types of pathology: diffuse and local. Below we will talk about each of them.

Diffuse thickening of the bladder wall in women, as a rule, is associated with muscle work. As you know, our ureter is a muscular organ that is needed in order to accumulate and retain fluid – urine. It is designed in such a way that when filled, the walls are irritated.This is how special nerve cells react.

Then the signal is transmitted to the brain and it already gives the command to excrete urine. The muscles contract. If urine output is not possible, then the muscle tissue contracts with a vengeance to allow urine to bypass the obstacle. If this happens regularly, then muscle mass builds up, which is why the walls of the bladder are thickened.

The second cause of diffuse thickening is chronic tissue inflammation. As already mentioned, you can see the pathology during an ultrasound examination.

The doctor who sent for examination must understand the true cause of such changes and choose an adequate treatment. Often this happens with cystitis.

Infection on the mucous membrane will cause a response and the walls will become thicker.

Local type violations. In this case, the seal of the walls of the bladder will be found in some of its zones, and not over the entire surface.

This may be due to a genetic trait affecting the structure of the urea.Often, the changes are acquired in nature. This happens with injuries, when hematomas are formed, and then dense thickenings.

Urea tuberculosis can sometimes be the cause of thickening.

ultrasound of the bladder

Ultrasound of the bladder is a method of examining the bladder, which is recommended if you suspect one of the diseases of the urinary system. Ultrasound of the bladder allows you to assess its shape, condition of the walls, contents and patency of the bladder neck (the place where the bladder passes into the urethra – the urethra).As a rule, it is recommended to undergo an ultrasound of the bladder if there is a violation of the outflow of urine, pain during urination, the presence of blood in the urine, injuries of the bladder, etc.

Preparation for ultrasound of the bladder

To obtain reliable results of the study, the bladder must be filled at the time of ultrasound. 30 minutes before the examination, it is recommended to drink about 1-1.5 liters of water and, if the urge to urinate appears, do not empty the bladder, but wait for the examination.

What diseases can be detected by ultrasound of the bladder?

Stones in the bladder can be primary (stones that have formed in the bladder) and secondary (stones formed in the kidneys that have migrated into the bladder with urine flow). Primary bladder stones are often formed in older men against the background of impaired urine outflow in prostate adenoma. Secondary stones in the bladder, as a rule, appear against the background of urolithiasis.Ultrasound of the bladder determines the presence of stones, their location, size, shape, number.

Cystitis is an inflammatory disease of the bladder. The main symptoms of cystitis are: frequent urination, pain during urination, false urge to urinate, etc. With cystitis, ultrasound shows a thickening of the bladder wall.

Bladder tumors are benign or malignant neoplasms in the bladder.Depending on the size and location, bladder tumors can cause different symptoms (for example, impaired urine flow). On ultrasound of the bladder, the presence of a formation that protrudes into the lumen of the bladder or protrudes outward is noted.

GBU RO “Design Bureau named after N. A. Semashko”

Department of functional diagnostics

Head of department Savinkina ON

causes, treatment, symptoms in men and women

Such a phenomenon as the thickening of the walls of the bladder does not arise for no reason as an independent process, but is associated with the course of concomitant pathologies of the urinary system.It is impossible to recognize this deviation on your own, but you can suspect its presence by a number of characteristic symptoms that will become the reason for a visit to the doctor. To reliably establish the disease, it is necessary to visit a urologist, get tested and undergo a cystoscopy or examination on an ultrasound machine. The capabilities of the equipment will allow you to study the structure of the walls, identify atypical formations (malignant tumors, polyps) and other abnormalities. When confirming the diagnosis, the doctor determines the tactics of treatment.When choosing therapeutic methods, they rely on the reasons that led to pathological changes in the bladder.

Signs of the disease

It is important to emphasize that the thickening of the bladder wall is provoked by various negative factors, for example, oncology. Therefore, timely recognition of atypical signs will help avoid health problems.

Symptoms, in the identification of which you should consult a doctor:

the appearance of sharp sudden pains, discomfort in the lower abdomen;
Constant painful urge to urinate, burning and cramps;
blood in urine;
after emptying there is no feeling of relief, but on the contrary, it seems that the bladder is full;
change in the color and consistency of urine, the appearance of a pronounced odor;
Laboratory analysis indicates the presence of proteins and an increased content of leukocytes in the urine.

Symptom criteria listed do not necessarily indicate that the bladder wall is thickened. However, these signs can signal an inflammatory process of the genitourinary organs, the presence of stones, malignant tumors and polyps. If, however, a discrepancy in the wall thickness with the established norms is revealed, then it is necessary to determine the cause that launched the pathological process.

Which leads to diffuse and local changes

Diffuse thickening of the walls of the bladder is due to the presence of infectious agents in the body, due to which the urinary system does not function fully, which creates an extra load on the walls of the organ.There are many nerve endings in the bladder that respond to how full it is by sending signals to receptors in the brain. This message is identified by the body as a command to urinate, which leads to the contraction of the muscle layer and the release of urine through the ureters. With dysfunction of the bladder, this process becomes difficult, which is expressed in the inability of the organ to normally get rid of the accumulated fluid. The result of the violation is a gradual thickening of the muscular membrane of the walls.

Diffuse changes occur for the following reasons:

Urolithiasis, in which there is a risk of a stone entering the ureter, which becomes the basis for fluid accumulation and an increase in internal pressure.
A formation has formed in the neck of the bladder that prevents the outflow of urine.
In men, the walls of the organ become thicker against the background of pathological abnormalities of the prostate gland, including obstruction. A detailed examination of the prostate is required.
Women are much more susceptible to the development of changes in the structure of the bladder due to anatomical features. The proximity of the urethra to the anus and vagina increases the risk of infection and inflammation. Such circumstances create ideal conditions for the onset of cystitis, which can also lead to thickening if left untreated.
The presence of congenital or acquired stenosis of the bladder neck.
Formation of diffuse thickening on the background of urethritis.This disease is characterized by chronic inflammation of the walls of the urethra.
Congenital and acquired enlargement of the calyx and renal pelvis, called hydronephrosis. It is required to examine the ureters and kidneys;
Presence of diverticulums in the bladder (bag-like protrusions). Emptying is carried out in stages – initially, fluid is released directly from the organ, and then stagnant urine from the diverticulum.
As a consequence of schistosomiasis.

Local thickening in the walls of the bladder does not affect the entire area of the organ, as with diffuse changes, but only a specific area.Such a deviation is characterized by an almost asymptomatic course, so the person does not suspect anything for a long time. Only qualified examinations and preventive examinations will help to recognize the changes that have begun in time.

A local process has an inherited or acquired nature. The main reasons leading to pathology:

the presence of congenital features in the structure of the bladder;
Formation of malignant tumors, polyps affecting the walls of the membrane, papillomas, stones;
complication of schistosomiasis;
against the background of tuberculosis of the bladder with the formation of granulomas, it is they that provoke multiple local deviations in the walls;
Mechanical trauma to the abdomen, provoking a hematoma on the bladder; 90,026 90,025 women are faced with local thickening due to current or past inflammation, infection of the genitourinary organs, irregular sexual activity.

A doctor will help to identify a reliable cause provoking an increase in the walls. He will listen to complaints, conduct a detailed examination, prescribe the necessary tests and carry out differential diagnostics.

Principles of treatment

The tactics and treatment regimen for thickened bladder walls determine the reasons that caused the development of the pathological process. General measures are aimed at treating concomitant urological abnormalities, normalizing the structure of the walls, eliminating inflammatory foci and infections, therefore, antibacterial drugs from the group of a wide spectrum of action and other agents are prescribed.As a rule, treatment is carried out:

Atropine;
Papaverine;
Nitrite;
Amisil;
Eufilin;
Cholenzime;
Nicodemus;
Allochol;
Oxafenamide.

The approximate duration of the therapeutic course in such cases is 2 weeks. If severe pathologies, malignant formations are found, hospitalization and treatment are required under the supervision of a specialist. To reduce the risk of consequences, it is likely that there will be a need for surgery and a course of chemotherapy.

If the changes are caused by problems with the prostate gland, then the man, in addition to antibiotics, is additionally prescribed physiotherapy, prostate massage, taking immunostimulants. When treating the bladder against the background of hyperplasia, a woman needs to combine therapy with hormonal drugs. In cases where the endometrium grows significantly or there are regular relapses, they resort to surgical intervention.

In conclusion, I would like to summarize and emphasize that structural changes in the walls of the bladder are just a clinical manifestation, and not an independent disease.This condition signals a malfunction in the organs of the urinary system, therefore, treatment should be comprehensive and primarily aimed at combating the main urological problem. A more attentive attitude to one’s own health, routine examinations by a doctor, and timely treatment of chronic inflammatory processes will help prevent such complications.

Possible causes and features of therapy

Thickening of the bladder wall is a frequent occurrence accompanying urolithiasis.It is possible to establish such a pathology only by performing an ultrasound examination.

Considering that the thickening of the bladder wall is not an independent pathology, but only a separate part of it, a specialist can send a patient to an ultrasound scan if there are symptoms characteristic of disorders of the urinary system. In the process of carrying out such a diagnosis, the doctor can determine the underlying pathology, as well as identify the process of compaction of the walls of the urinary organ.

Complaints

The main reason for referring a patient to an ultrasound scan are his complaints and the symptoms listed by him, indicating the development of a pathological process.

Frequent urge to urinate, which are accompanied by acute pain and cuts in the lower abdomen, may be manifestations of the inflammatory process. The advancement of the stone, cancer formation can also cause the occurrence of similar symptoms.

Signs

Hematuria is one of the signs of thickening of the bladder wall, which should alert the patient. At the same time, the urine acquires a red tint, when the bladder is emptied, pronounced cramps and burning are felt.

It should also be alerted that at the time of urination the patient feels that the bladder has not completely emptied.

If, during a laboratory study of urine, a protein or an increased number of leukocytes was detected, the urologist must send the patient for a diagnostic examination.

Thickening of the bladder wall is divided into local and diffuse, each of which has characteristic causes.

Diffuse compaction

This type of pathological process can provoke inflammation or a sudden increase in the load on the muscular layer of the organ.The bladder is a hollow muscular organ whose main function is to retain urine. The process of urination occurs in such a way that when the bladder is filled, its nerve endings are irritated, after which a signal is sent to the brain about the need to empty it. The muscles begin to contract, which facilitates the passage of urine. In case of urolithiasis, the stone can block the flow of urine. In this case, the muscle layer of the bladder will continue to contract in order to remove it, despite the obstacle.Frequent and prolonged muscle tension contributes to an increase in muscle volume, and subsequently leads to a thickening of the walls of the bladder.

The tumor can also block the ducts in any part of the urinary system. Thickening of the bladder wall is observed due to malfunction of the prostate gland, its increase in size, which provokes the process of squeezing the urethra, blocking the normal outflow of urine. If a thickening of the bladder wall is found in men, a specialist should examine the prostate gland and prescribe treatment.

Inflammation of the bladder can also cause thickening of its walls. That is, cystitis is a common cause of this pathology. The urinary organ is exposed to this disease as a result of severe hypothermia, the presence of infection, trauma to the mucous membrane of the organ. Infection is the main reason for the development of this pathology. Penetrating into the bladder cavity, it affects the submucosal and mucous layers. This contributes to the development of serious pathological changes that lead to a thickening of the walls of the bladder.

Local compaction

Local compaction does not extend completely to the surface of the muscle layer and the mucous membrane of the bladder, but only to a specific area of the organ.

The cause of this pathological process is a hereditary factor, especially in situations where a patient has a specific organ structure that differs from the standard one.

However, a local type of the disease can be acquired in the course of life.Any trauma to the bladder can affect the structure of the walls, provoke the development of hematoma, and in the future lead to thickening of its walls.

Benign or malignant neoplasms, polyps, papillomas during ultrasound are manifested in the form of a hyperechoic formation in the bladder, which may be indicated by the entry of renal calculus into the bladder.

In some cases, the presence of a parasitic pathology – schistosomiasis – indicates increased echogenicity. Tuberculosis of this organ can cause the walls of the bladder to harden.

Specific visual signs may be absent, therefore, a specialist can determine this pathology only after a diagnostic examination.

Why is there a thickening of the bladder wall in women?

Causes

Even a slight thickening of the walls is caused to the greatest extent by a variety of inflammatory and infectious processes. It is much easier for all bacteria and other infections to enter the bladder of women, since the length of their urethra is somewhat shorter than that of men.Therefore, this pathological condition is observed mainly in them. In addition, the disease often develops in those patients who have low sexual activity. And, finally, urolithiasis is the main reason for the compaction of the walls of the bladder.

A thickening of the walls of the bladder in a child can also be found. Symptoms need to be identified in a timely manner because children often cannot talk about their concerns. After all, the child may not even feel discomfort.

Diagnostic measures

Due to the fact that the thickening of the muscle layer cannot be classified as a major pathology, but only to their clinical manifestation, experts direct their actions to determine the true disease in order to prescribe drug therapy in the future.

Carrying out ultrasound examinations is considered a fundamental method for diagnosing such phenomena and allows you to establish urological pathologies that pose a danger to the bladder.For the full implementation of this study, the patient is recommended to consume a large volume of water before the procedure. It is imperative that the bubble is filled with liquid as much as possible. At the same time, a specialist will be able to detect any pathological formation, establish its localization and degree of risk.

In addition, such a study helps to determine the size of the organ, and in developing pathological processes, the small size of the bladder is quite often observed, which is unable to hold a large volume of urine, as a result of which the muscles have to remain in constant tension.This provokes a thickening of the walls of the bladder.

Treatment

Therapeutic assistance in the development of such a condition depends on the causes of its occurrence. In case of inflammatory diseases that caused induration, the following medications are used:

antibacterial – Ciprofloxacin, Amoxicillin, Ceftriaxone, Levofloxacin;
antispasmodics – “Papaverine” “No-shpa”;
NSAIDs – Ibuprofen, Indomethacin, Meloxicam.

In the case when the hypertrophy has arisen due to trauma or hereditary factors, the treatment usually involves surgery.Therapy is determined separately in the case when the cause of the pathology is urolithiasis. The method of removing the calculus depends on its size, type and location. Small stones are removed with antispasmodic medications, which dilate the urinary tract. For large calculi, ultrasound crushing or surgical removal is used.

Oncological etiology of the development of seals in the bladder requires combined treatment: chemotherapy, surgery and radiation therapy.

If the cause of hypertrophy is prostatitis or an enlarged prostate, help is directed primarily to the treatment of the underlying disease, and then to the bladder. The causes and treatment of bladder wall thickening are interrelated.

Recovery

After therapeutic measures, the recovery process begins, in which some medications or physiotherapy can also be prescribed. These include:

antibiotics;
immunotherapy;
prostate massage;
physical activity;
giving up bad habits.

Traditional medicine

Alternative medicine can also help, for example, an infusion of mint, a decoction of dandelion roots, carrot broth, infusion of celandine, aloe, etc. Such agents are prepared according to special recipes.

We examined the causes of the thickening of the bladder walls.

Bladder and urethral pathology in cats and dogs

Bladder volume

In humane medicine, the measurement of urine volume by ultrasound is widely used, with particular attention to the accumulated volume of urine and the residual volume after urination.When calculating the volume of urine in humans, the following formula is used: volume = length X width X height X 0.523. In dogs, the latter coefficient has been changed to 0.625, which more accurately determines the estimated volume of urine.

In the practice of small pets, ultrasound calculation of urine volume by ultrasound can be used to assess conditions such as: bladder contractility, neurogenic bladder, obstruction of urine outflow. In dogs and cats, urine volume measurements may also be helpful in assessing the degree of bladder dysfunction during medical or surgical treatment.Also, ultrasonic measurement of residual urine volume is used to assess canine dysuria and the success of surgical treatment for herniated lumbosacral intervertebral discs.

Position of the bladder neck

Ultrasound identification of the location of the bladder neck can provide the veterinarian with some data that are somewhat contradictory in meaning and content (the usefulness of these measurements remains unclear). Displacement of the bladder into the pelvic canal is established when> 10% of the organ is there, and this deviation may require colposuspension (at the discretion of the doctor).

In the practice of small pets, ultrasound is used to determine the change in the position of the bladder neck in healthy dogs and in dogs against the background of the sphincter mechanism of urinary incontinence, which often develops during rest or relaxation of the animal. On analysis of the data, it was found that dogs with urinary incontinence had a greater degree of caudal bladder movement under anesthesia. The theory has been hypothesized that incontinence may be related to a deficiency in a vesicourethral support mechanism.Also, with this form of incontinence, the bladder may also be abnormal and not constrict normally at the junction with the urethra.

So, ultrasound of the urinary bladder for incontinence can exclude visible causes (eg ectopia of the ureter, see above), and helps in the diagnosis of sphincter incontinence by assessing dynamic changes in the position of the bladder neck. It should be noted that with caudal displacement of the bladder neck, it is very difficult to exclude other causal incontinence due to poor visualization of the bladder trigone umbrellas (difficulties in diagnosing ureteral ectopia).

Also, a comparison was made between stress urinary incontinence in women and sphincter incontinence in bitches, and scientists found a lot in common between them. It was noted that both in women and in bitches with these diseases, a shortening, compared to the norm, of the functional urethra area is determined, as well as a low maximum pressure in the urethra.

Urachus anomalies and acquired diverticula

Contrast radiographic examination is the best method for assessing the position and extent of diverticula (congenital and acquired) and fistulas.Ultrasound in these cases plays an auxiliary role, but some pathologies of the urachus, diverticula and fistula may be suspected during ultrasound of the bladder (which is often performed before radiography) and serves as a reason for further diagnosis.

Urachus plays an important role during the period when the animal fetus is in the uterus, it connects the bladder with the allantoic sac. After the birth of an animal, the urachus undergoes regression and transformation into fibrous masses. In case of violation of the reverse development of the urachus, the development of the following pathologies is likely: persistent (open) urachus; urachus diverticulum; urachus cyst.

Persistent (open) urachus – preservation of the connection of the bladder with the external environment in the navel. It is clinically expressed in urine leakage in the navel area (only wetted hair can be observed); in the supine position, the formation of dotted leaks is likely. The main diagnostic method is contrast cystography, ultrasound is an auxiliary method. On ultrasound examination against the background of an open urachus, it is determined between the cranioventral part of the bladder wall and the umbilicus, and is suspected in cases of a change in the contour of the apex of the bladder (unusually raised, pointed appearance).The wall of the bladder itself with persistent urachus is often thickened. The main method of treatment for persistent urachus is surgical correction (direct indications), it leads to a complete cure.

Urachus diverticulum (s) – weak protrusion of the bladder tissue at the apex, with incomplete closure of the urachus of the fetus. Probably the development of a secondary urachus diverticulum secondary to urethral obstruction or idiopathic feline cystitis. The urachus diverticulum predisposes the animal to the development of bacterial colonization of the urinary bladder, and may contribute to the development of signs of idiopathic cystitis.The main diagnostic method, as well as with persistent urachus, are contrast radiographic imaging methods; An ultrasound scan only helps to suspect a diverticulum. Ultrasound examination of urachus diverticula usually reveals fluid-filled structures extending from the bladder lumen. Diverticula can vary significantly in size, and the wall can thicken in chronic cystitis with prolonged course. Removal of diverticula (diverticulectomy) is indicated only if there are clinical signs, i.e.,Because a urachus diverticulum may predispose the bladder to recurrent infection, asymptomatic animals are not treated.

It should be remembered that urachus abnormalities are localized in the cranioventral wall of the bladder, between the bladder itself and the umbilicus, while acquired diverticula can develop at any location. Diverticula in the bladder wall can form due to trauma or cystitis.

Urachus cyst forms under the condition of continued secretion of an isolated part of the urachus epithelium, while the remaining urachus undergoes fibrosis and regression.Typically, on ultrasound, urachus cysts appear as thin-walled, anechoic structures cranial to the bladder. Probably infection of the cyst and the formation of an abscess (with a corresponding appearance on ultrasound) Contrast cystography also remains the main diagnostic method, and surgical excision of the urachus cyst is the treatment of choice.

Also described is such a pathology as preserved urachus ligament , it pulls the bladder cranially to the navel and prevents adequate emptying in cats, leading to lengthening of the bladder and the formation of a pointed apex.Surgical dissection of this ligament leads to the animal’s recovery.

Ultrasound of the bladder can detect herniation (hernia) of intact mucosa through a tear in the muscle layer of the bladder wall after traumatic exposure. But the diagnosis must also be confirmed by contrast cystography. Also, with ultrasound of the bladder, deformation of the lumen and adhesion of the bladder may be suspected; confirmation of the diagnosis of these pathologies requires a contrast radiographic examination.

Duplication of the bladder

Duplication of the bladder is a rare condition described in dogs. Ultrasound allows us to suspect this pathology, the final diagnosis is carried out by means of plain and contrast radiography. Duplication of the bladder can predispose an animal to urinary tract infection and urinary incontinence, and surgical correction is the main treatment.

Ruptured bladder

If you suspect a ruptured urinary tract (pr.in trauma), expert means of assessing their integrity are various methods of contrast imaging (excretory urography, contrast cystography and urethrography). Ultrasound in these cases can only play an auxiliary, and far from the main, role. Also, with ultrasound of the bladder, wall rupture may be mistakenly suspected due to interruption of the curved wall signal (marginal or refractive artifact). In addition, small wall defects may not be visualized by ultrasound and lesions to other parts of the urinary tract may be missed.

Cystitis

During ultrasound examination of the bladder against the background of cystitis, asymmetric thickening of its walls is most often noted, this phenomenon is most pronounced in the cranioventral section, but, in severe cases, generalized thickening may be noted. The normal wall thickness of a distended bladder is in the order of 1–2 mm. When the bladder collapses, a subjective assessment of the wall thickness is required, based on the degree of stretching.In many cases of cystitis, the bladder wall is normal, this may be true even in the presence of sediment or stones. Ultrasonic thickening of the bladder wall (hypoechoic, hyperechoic, or stratified) is often combined with other findings such as stones, debris, or blood clots. And again, ultrasound data for cystitis are often auxiliary, and a combined use of other examination methods is required to establish the final diagnosis.

Polypoid cystitis is a rare form of cystitis described in dogs.Ultrasound examination of the bladder, with this form of cystitis, reveals hyperechoic masses (polypoid or pedunculated) protruding into the lumen of the bladder, as well as diffuse thickening of the walls (the latter is not always the case). Polypoid masses are characterized by a certain localization, more often they are located on the cranioventral wall of the bladder, in rare cases they can be located craniodorsally.

The main differential diagnosis in polypoid cystitis is a neoplasm of the bladder (usually transitional cell carcinoma of dogs), in case of any doubts, a catheter biopsy (suction biopsies) should be performed, followed by cytological examination of the samples.It should be remembered that neoplasms of the bladder are much more common than wall polyps.

Emphysematous cystitis is a separate form of cystitis, characterized by the formation of gas by bacteria such as: Escherichia coli, Aerobacter aerogenes, Proteus mirabilis, and Clostridium sp. This type of cystitis is more often observed in animals against the background of diabetes mellitus, during the fermentation of urine glucose by bacteria. An ultrasound view in emphysematous cystitis is characterized by the detection of a multifocal, hyperechoic surface of the bladder of irregular shape with a reverberation artifact and the formation of a dirty shadow.

The free gas of the bladder lumen (often observed during catheterization) is differentiated by changing the position of the patient and / or the sensor (free gas moves with the change in the position of the patient). Radiography of the abdominal cavity acts as an auxiliary method for diagnosing emphysematous cystitis, it reveals the glow of the bladder wall.

Pseudomembranous cystitis has mainly been described in humane medicine, but can also occur in cats. This type of cystitis is associated with severe diffuse ulceration, necrosis and hemorrhage in the bladder wall, as well as with intraluminal necrosis, and the formation of free fibrinous and germrhagic septa and debris in the lumen.The accumulation of tissue and debris in the lumen predisposes to obstruction of the flow of urine through the urethra. The ultrasound picture with pseudomembazous cystitis reveals a thickening of the walls of the bladder, the presence of echogenic debris and septa that break the bladder into small sections.

Cystitis with inversion of the bladder walls is a rather rare condition, it can be asymptomatic, and can cause signs of bladder inflammation. The ultrasound picture reveals a thickening at the apex of the bladder in the form of masses, or a fold of the bladder protruding into the bladder.Inversion leads to the formation of incised serous borders of the bladder. The thickening of the inverted wall retains the layering, leading to the formation of a characteristic mixed (hyper- and hypoechoic) species. This condition can also occur after long-term placement of a urinary catheter.

Blood clots in the lumen and hemorrhages of the bladder walls

Blood clots in the lumen of the bladder and wall hematomas can form for the following reasons: trauma, hemostasis disorders, infection, neoplasia.Blood clots are expected findings with appropriate medical history and clinical signs. Clots with ultrasound are usually hyperechoic, without a shadow, irregular in shape, displaced according to the law of gravity. In the presence of large clots or their adhesion to the wall of the bladder, their vernal appearance may be more echogenic with less mobility, which leads to an erroneous diagnosis of mural masses. To differentiate between neoplasms of the urinary wall and blood clots (or hematomas), Doppler can be used; in the formations, it reveals some vascular lesions.Manipulation of intermittent pressure of the transducer on the bladder temporarily suspends small clots in the urine (lifts), this phenomenon is not observed in the presence of mural masses or large uroliths.

Ultrasound examination of intramural hematoma reveals masses of different echogenicity (usually hypoechoic) inside the thickened wall, they can be linear or round. A Doppler study helps to distinguish a hematoma from formation by a lack of blood flow in the focus of hemorrhage.Also, repeated research helps to differentiate neoplasia and inflammatory diseases of the urinary wall secondary to hemostasis disorders, with appropriate successful treatment – the hematoma resolves at a rate of about 1 mm / day. With trauma, there may be concomitant bladder lesions in the form of free fluid around the outer wall, and a suitable medical history or accompanying signs of recent trauma may help in making a diagnosis.

Intramural hematoma gradually resolves if it does not lead to the formation of necrosis of the bladder wall and urine leakage into the abdominal cavity.

Bladder stones

A typical ultrasound view of radiolucent and radiopaque bladder stones are hyperechoic foci, with an artifact of shading in the dependent part of the bladder lumen (lower, facing the ground). Bladder stones are heavier than urine and tend to migrate into the dependent part of the lumen, in rare cases, they are likely to stick to the wall against the background of severe inflammation. Uroliths usually have a spherical shape, their surface is hyperechoic and curvilinear, their number and size are varied.

Ultrasound identification of uroliths in the bladder using modern equipment has the same accuracy as contrast radiographic examination. However, compared to other imaging techniques, ultrasound tends to increase the true dimensions of uroliths by a few millimeters.

The degree of shading of bladder stones varies considerably and depends on such factors as: composition and density of uroliths; their location in the focal zone of the sensor; the frequency of the ultrasound used.The presence of shading correlates poorly with the composition of stones, the shading becomes most pronounced when using a higher frequency of ultrasound, with the location of uroliths in the focal zone of the sensor. In the presence of small stones (not exceeding the width of the ultrasound beam along the x or Z axis), the shading artifact usually does not appear. Ultrasound identification of suspect bladder stones facilitates the use of color Doppler; the presence of uroliths is determined by the presence of a twinkling artifact.

Difficulties in identifying stones may arise in the presence of sediment; it is more often localized in the dependent part of the lumen of the bladder and can give shading. However, the sediment is easily suspended when exposed to the bladder, and if there are no stones, there is no way to observe the dixretic echogenic foci of uroliths. The accumulation of small stones or mineralized sediment in the dependent part of the bladder is capable of creating a linear surface with a shade of varying severity. The presence of a dependent sediment without a shadow indicates the presence of non-mineral substances (ex.cellular debris) or a small amount of salts with crystalluria. Less echogenic pyuria may appear on ultrasound as an echogenic accumulation in the dependent part of the bladder. Unlike sediment and stones, gas bubbles rise up in the bladder, but they also create a shadow, and must be differentiated from the reverberation artifact of the near fields. Both sediment and gas bubbles change their localization with the change in the position of the patient’s body.

Fibrosis or calcification of the bladder wall can form mural hyperechogenicity and shading.In most cases, repositioning or visualizing the transducer in multiple planes (together or separately) helps to distinguish fibrosis or calcification from stones, blood clots, sediment, or gas bubbles.

For the newcomer to ultrasound diagnostics, the colon has a hyperechoic surface, creates a shading artifact and can mimic large bladder stones. To differentiate this phenomenon, the movement of the transducer in the longitudinal plane defines the colon as a linear surface along the entire length of the image, while the stones must remain spherical.In addition, a change in position of the animal (standing or on its side) should lead to a change in the position of stones in the lumen of the bladder, while the colon remains in one position.

Foreign bodies of the urinary bladder

Examples of foreign bodies in the bladder are pathologies such as: an abandoned catheter, an awn of cereals, suture material. The catheter is presented in the form of parallel echogenic lines when the ultrasound beam is perpendicular to the wall, parallel lines represent the catheter walls.The awns of cereals have a different appearance, but they can be presented as hyperechoic structures without shading. In case of reaction to the suture material of the walls – the site of the operation appears to be thickened, it is likely to determine the suture pattern.

Neoplasms of the bladder

Transitional cell carcinoma (TCC) of the bladder is the most common type of tumor in this location. Most often affects dogs, almost never occurs in cats. There is a possibility of detecting other types of bladder tumors; they can be epithelial in origin (squamous cell carcinoma, adenocarcinoma) and mesenchymal (uviform rhabdomyosarcoma, tumors of the peripheral nerve sheath, leiomyoma, leiomyosarcoma, fibroma, fibrosarcoma, osteosarcoma, lymphoma, mycodonitis).By means of ultrasound, it is impossible to distinguish the type of tumor, as well as to distinguish it from a benign formation, however, neoplasms of epithelial origin have an intraluminal protrusion of an irregular shape, while mesenchymal tumors give a smooth surface (both mucous and serous). Due to the fact that transitional cell carcinoma of the bladder is the only type of tumor often found in the veterinary practice of small pets, we will talk about it further. In case of various doubts, it is better to send an animal with education to a reference veterinary clinic.

The characteristic localization of transitional cell carcinoma of the bladder is the trigone zone and the dorsal wall of the bladder; in rare cases, any other localization or diffuse involvement of the wall can be noted. An ultrasound view of this tumor is usually presented as its thickening and change in shape with the formation of masses protruding into the lumen of the bladder with a wide attachment. The echogenicity of the lesions is often mixed, and the general appearance may be weak or echogenic. With tumor mineralization (there is a possibility of development), differentiation of intramural lesions from intraluminal uroliths is required.With diffuse involvement of the bladder wall and the absence of local masses, the appearance of the thickening should be differentiated from thickening in severe and chronic cystitis.

With the localization of transitional cell carcinoma of the bladder in the area of the papillae of the ureter, the development of obstruction and expansion of the ureter (unilateral and bilateral) is likely. With this type of neoplasm, invasion of the tumor into the proximal urethra often occurs. However, the transfer of the tumor from the prostate and ureter to the bladder is possible.Dogs with transitional cell carcinoma often have concurrent urolithiasis, urethritis, cystitis, and / or blood clots.

As mentioned above, the differentiation of the type of tumor is possible only through cytology and / or pathomorphology. But performing a percutaneous biopsy in dogs with transitional cell carcinoma is controversial (rather contraindicated). promotes the spread of cells along the canal of the needle (more often the development of a secondary tumor on the ventral wall of the abdominal cavity).Therefore, for the diagnosis of this type of tumor, the preferred method of establishing the final diagnosis is catheter biopsy (possibly under ultrasound guidance).

For tumor staging, ultrasound is used to assess the sub-lumbar (iliac) lymph nodes, and ureteral obstruction is excluded by visualizing both the ureter itself and the degree of filling of the renal pelvis. The operator must remember that tumors of the ureter or prostate can extend into the bladder, representing a urinary tumor.To complete the complete staging of the tumor, in addition to microscopic examination of the samples, radiographic examination of the thoracic and abdominal cavities is required (metastasis to the lungs, assessment of the iliac lymph nodes, pelvis and lumbar spinal cord). Complete staging of transitional cell carcinoma of the bladder can affect the prognosis of the disease.

Pathology of the urethra

The value of ultrasound evaluation of the urethra in dogs and cats is difficult and anatomically limited.The most beneficial is the evaluation of the proximal urethra in bitches and the prostatic urethra in males. The use of modern intraluminal high-frequency equipment makes it possible to assess the entire length of the urethra (determination of urethral tumor, assessment of metastases, localization of stones), but this type of study is still out of reach and remains the domain of reference veterinary clinics. With significant sizes of urethral stones, ultrasound can determine the shadow, the structure itself and the displacement of the urethral wall outside, but many urethral stones are small enough and do not give a shadow.The connection of the urethra with the vagina and rectum is better assessed by contrasting types of research, ultrasound in this case does not play a significant role. Ultrasound can help diagnose prostate tumors invading the urethra and extending to the bladder neck.

90,000 reasons, treatment of women, men and children

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There are many diseases in which the bladder wall thickens. Such hypertrophy of the walls of the organ is the main symptom in the diagnosis of diseases of the genitourinary system.

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The diagnosis of such diseases is difficult, but if you use ultrasound, the result can be obtained immediately for all patients, even for children. If an incorrect drug treatment regimen is not detected or prescribed in a timely manner, the disease turns into pathology, since most often the thickening of the bladder wall appears due to inflammation from infectious diseases.

Why is there hardening of the bladder?

Main symptoms

Urolithiasis, leading to disorders of the genitourinary system.With a significant size of the stone, it blocks the pathways for urine output, accumulation of fluid and an increase in internal pressure occurs;
Neoplasm in the neck of the bladder, the narrowest point at which the urine outlet is blocked. Thickening of the walls of the bladder in men occurs due to the pathology of the prostate, which is accompanied by impaired deurination due to the pressure of the enlarged gland on the urethra. That is why male patients with malfunctions of the bladder need to do an examination of the prostate gland;
Features of the anatomical structure of the genitourinary system in women, consisting in a short and wide enough urethra, located close to the anus and vagina.The walls of the bladder thicken due to vulnerability to inflammatory diseases, and cystitis can also be the cause. A similar disease can occur in men, but much less often;
Narrowing at the junction of the urinary tract and bladder, called cervical stenosis. Stenosis can be either acquired due to previous diseases or congenital;
Lumps in the bladder are often caused by urethritis, in which they become inflamed in the urinary tract;
The presence of a diverticulum, a sac-like depression in the wall of the urethral canal.It is also possible to locate it in the cervical region, which interferes with natural urination.

Local pathology

Local type compaction differs from diffuse pathology in its spread not along all the walls of the organs, but in a specific area of its tissues. With thickening of the walls of this type of symptoms, there are practically no symptoms, which significantly complicates the diagnosis. The situation can only be helped by a regular planned examination, since the pathology of the local type is hereditary or acquired in nature.

The most common causes are as follows:

Peculiarities of the anatomical structure of the patient’s bladder;

90,025 polyps, papillomas, neoplasms, both malignant and benign, as well as stones;

dysfunction of the bladder of nervous etiology;
condition of schistosomiasis due to parasite infestation;
tuberculosis of the bladder;
injury and damage to internal organs;

90,025 in women with inflammatory processes, as well as irregular sexual activity or infection of the external genital organs.

Hyperplasia

Symptoms of hyperplasia

Thickening of the walls of the bladder with hyperplasia in men is characterized by the following symptoms:

No.	Useful information
1	frequent urination and polyuria, as well as frequent urination
2	nocturia, in which a significant volume of fluid is excreted at night 9099
3	feeling of incomplete urination and not emptying bladder
4	urination in the form of drops at the end of deurination
5		sexual disorders	interruption	urine with weak pressure and the need to push.It is also possible to have painful sensations

In women, symptoms are an irregular menstrual cycle, acute pain and massive bleeding. In some cases, amenorrhea occurs when menstruation is absent for six months or more.

How to identify thickening of the walls in the bladder?

The beginning of diagnosis with an increase in the walls of the bladder begins with the collection of the patient’s anamnesis, after which additional studies are prescribed.The most effective and informative is the ultrasound of the bladder, which is performed on an organ filled with fluid. Only in this state can the doctor see a change in the thickness of the walls and signs of chronic diseases.

To find out the nuances, it is necessary to undergo an X-ray examination, which will reveal the degree of damage to the walls. You can also use cystoscopy, which examines the organ from the inside, showing uneven surfaces in the mucosa, both front and back.With cystoscopy, it is often possible to determine the presence of a tumor and the extent of its spread, as well as other abnormalities.

Treatment

Antibiotics are often accompanied by treatment with antibacterial drugs, which include Cholenzym, Allochol, Nicadim and Oxafenamide. Papaverine, Nitrite, Amisil, Atropine and Euphyllin are just as effective. If a tumor is found on examination, it is necessary to carry out chemotherapy and surgery

In the treatment of male prostatitis, therapy should be comprehensive, including physiotherapy, prostate massage and correction of immunity. In women, hyperplasia is treated with drugs containing hormonal substances, but if there is endometriosis or its relapses, surgery is necessary.For each patient, treatment is prescribed individually, based on the history and complexity of the disease.

Traditional medicine

Traditional medicine with its plant substances can not only remove the seal of the walls in the organ, but also get rid of neoplasms and tumors with regular intake of phyto-drugs. Each of the recipes is useful, but you must first check the body for allergic reactions to plants.

Patients are recommended herbal teas from dandelion leaves, toadflax, mint, flowers and leaves of tansy, cinquefoil roots.Also useful will be tinctures of carrots, black radish, beets, aloe, vodka and honey.

The most popular folk remedy is ordinary millet, half a glass of which is washed and left in half a liter of clean hot water. After 15-15 minutes, shake the infusion and drink 150 ml up to five times a day for 15 days. Taking this remedy will reduce pain and cleanse the urinary ducts. Porridge made from this grain is also useful in any form.

Corn silk in the form of a decoction can relieve inflammation and reduce the intensity of pain.To do this, pour a tablespoon of the dry mixture with cold water, at least three glasses. Better to take clean water, but not from the tap. The broth is cooked for half an hour on a small window. Three times a day before meals, you need to take the resulting liquid in its pure form. It is forbidden to take this remedy for thrombophlebitis or varicose veins.

Everyone’s favorite pumpkin seeds are ground in a blender. The resulting cake must be boiled for three minutes, insisted for a couple of hours and drunk two liters a day.It is not necessary to filter, it is important to drink with the sediment.

When cooking, carrot tops are often left, especially if the house has a personal plot and vegetable garden. A handful of carrot tops and half a liter of boiling water are infused for about an hour. Further, the tincture is taken 4-5 times a day before meals.

Dill, which is effective both in the form of herbs and dried seeds, successfully fights against many diseases of the genitourinary sphere. A tablespoon of seeds and a glass of cold water are placed on the stove and boiled for several minutes.The broth is filtered and drunk 50 ml three or four times a day.

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90,000 what is it, norm, reasons, treatment

Causes and treatment of thickening of the walls of the bladder

It is difficult to determine such changes, but with the help of an ultrasound examination it is quite possible.

Varieties of pathology

By the type of thickening, diffuse and local diseases are distinguished.

Diffuse type of disease

This thickening of the walls can cause inflammation or a sudden increase in muscle stress.

The signal sent to the brain returns as a command to the beginning of urine drainage, after which the muscle tissue begins to contract.

Wall thickening may appear due to cystitis. Having penetrated into the urinary tract, the infection will affect the mucous membrane, provoke changes, which will cause the appearance of thickenings.

Local type of disease

It is not distributed over the entire surface of the walls, but only in small areas.One of the reasons may be heredity associated with some features of the structure of the genital organs.

It happens that local pathology is acquired in the process of life. Corrections can be made by trauma to the bladder, provoking the appearance of hematomas preceding thickening.

Formations of a malignant and benign nature, papillomas, polyps, detected by ultrasound of the bladder, are manifested as hyperechoic formations. An ordinary stone can look in the same form.

The walls of the bladder can also become hardened due to tuberculosis. True, external signs in this case do not appear, and to identify pathology, the doctor will need a diagnostic examination.

The main causes of pathology

There are nerve endings in the bladder that are triggered when it is full and send signals to the brain. The result of decoding them is very simple – it became necessary to empty the urine.

Ultimately, the muscles contract, urine is directed outward along the urethra.If the bladder does not work properly, then it is not able to “push out” the accumulated volume of fluid, which causes a gradual thickening of the muscle layers.

There are some other reasons for the thickening of the bladder wall:

New lesions in the narrow area of the neck , which can also block the urine channel.
Narrowing of the opening , which connects the bladder with the discharge channel, causes diffuse pathological manifestations.This is a stenosis, which is congenital or acquired as a result of past diseases.
Urethritis – an inflammatory process of a chronic nature in the urinary tract.
Diverticulum. This is a saccular depression in the walls of the urethra, located near the neck and interfering with the normal flow of urine.

Features of the seal

This disease also occurs in children. It is very important here to identify the symptoms in time, because children are often unable to explain what ultimately bothers them.Note that the child may not even feel discomfort.

For small patients, the formation of suspension in most cases is not a pathology, and in order to make a diagnosis, you will have to organize a thorough examination. The age category of the patient is also considered important – this will determine the volume of fluid in the bladder, which is a normal phenomenon.

Women have an anatomical feature – the urethra is wide and small in length, located quite close to the anus and vulva.

The walls of the urea can become thickened due to a tendency to inflammation of the ureter – the so-called cystitis.

The disease is inherent in men, but among them it is very rare. Here the main reason may be the pathology of the prostate.

Clinical manifestations of the disease

The first sign is the increased frequency of visits to the toilet.

If we talk about men, they will experience frequent urge to pass urine. During the day, the amount of emission will increase, at night, urine will be diverted abundantly.

For women, the main symptom is menstrual irregularities, severe bleeding, acute pain. Amenorrhea is possible – when periods are absent for six or more months.

Necessary research

The disease is not the main one, it is considered a clinical manifestation, so doctors have to identify real pathologies in order to prescribe the correct treatment course.

Research is carried out using ultrasound.Before that, the patient needs to drink a lot of liquid so that the water fills the entire volume of the organ.

How is pathology therapy carried out?

In cases of exacerbations, drugs are prescribed against microbes and parasites – Nikodim, Holenzim, Amisil and others. If a tumor is detected, chemotherapy or surgery is performed.

As folk remedies, you can use mint tea, dandelion infusion, celandine. Vodka tinctures made from beet, carrot, black radish, aloe, honey juices help a lot.

Preventive measures

It is recommended to adhere to special diets that normalize metabolism, observe hygiene requirements, prevent hypothermia, play sports, and treat inflammatory diseases in time.

Why is the thickening of the walls of the bladder dangerous?

4 minutes to read

Thickening of the walls of the bladder is a pathological condition that is often diagnosed. Hypertrophy develops in various diseases, is often asymptomatic, but can lead to serious complications.Therefore, it is important to know about the reasons for its appearance.

Content

What is
Classification
Reasons
Symptoms
Diagnostics
Treatment
Complications
Forecast
Prevention

What is

The walls of the bladder are thickened most often in women due to anatomical features. The wide and short urethra is located close to the anus and vulva.Often, hypertrophy occurs with cystitis, when an inflammatory process develops in the ureter.

In men, pathology is extremely rare. Almost always in this case, diseases of the prostate gland lead to thickening. The enlargement of the prostate disrupts the process of urination, the inflamed organ presses excessively on the narrow and long urethra. All this leads to bladder disorders.

Classification

According to the type of development of hypertrophy, pathology is divided into diffuse and local types.In the first case, the thickening of the bladder wall often leads to inflammatory processes, excessive stress on the muscles.

When the outflow of urine is blocked, the muscle tissues are overstrained, trying to push the urine. Multiple contractions over a long period of time increase muscle mass, which causes the walls to thicken.

With the local type, hypertrophy is detected only in small areas of the surface. The main reason for this process is considered to be a genetic predisposition.

Reasons

Thickening of the muscle layers of the organ occurs for the following reasons:

Due to genetic predisposition , in which children suffer from the disease.
Due to the presence of inflammatory processes of an infectious nature – cystitis, urethritis.Even after therapy, the formed seal does not disappear, and after a relapse, the problem is only aggravated. Due to the anatomical features of the structure of the urethra, women are more likely to suffer from inflammation.
With an excessive activity of wall muscles. This condition occurs in the presence of urolithiasis, when the urethra is partially blocked, the bladder contracts, trying to push the urine. In men, hyperplasia occurs due to inflammation, enlargement of the prostate gland.
Due to diverticulum. A saccular depression in the urethra is located near the cervix and prevents the normal outflow of urine.

Another disease is formed with benign or malignant tumors, polyps, papillomas, tuberculosis of the bladder, violation of innervation, when nerves are clamped, roots in the spinal column. Mechanical damage to the organ, urethra, parasitic infections also provoke the development of hyperplasia.

Symptoms

Amenorrhea often appears when there is a long delay in menstruation. Another symptom of wall thickening is hematuria, in which urine is excreted along with blood impurities.

Diagnostics

Thickening of the walls of the bladder

Such a phenomenon as the thickening of the walls of the bladder does not arise for no reason as an independent process, but is associated with the course of concomitant pathologies of the urinary system. It is impossible to recognize this deviation on your own, but you can suspect its presence by a number of characteristic symptoms that will become the reason for a visit to the doctor.To reliably establish the disease, it is necessary to visit a urologist, get tested and undergo a cystoscopy or examination on an ultrasound machine. The capabilities of the equipment will allow you to study the structure of the walls, identify atypical formations (malignant tumors, polyps) and other abnormalities. When confirming the diagnosis, the doctor determines the tactics of treatment. When choosing therapeutic methods, they rely on the reasons that led to pathological changes in the bladder.

Signs of illness

It is important to emphasize that the thickening of the bladder wall is provoked by various negative factors, for example, oncology.Therefore, timely recognition of atypical signs will help avoid health problems.

Symptoms, if any, you should consult your doctor:

the appearance of sharp sudden pains, discomfort in the lower abdomen;
Constant painful urge to urinate, burning and cramps;

90,025 blood in urine;

after emptying there is no feeling of relief, but on the contrary, it seems that the bladder is full;
change in the color and consistency of urine, the appearance of a pronounced odor;
laboratory analysis indicates the presence of proteins and an increased content of leukocytes in the urine.

Which leads to diffuse and local changes

Diffuse thickening of the walls of the bladder is caused by the presence of infectious agents in the body, due to which the urinary system does not function fully, which creates an extra load on the walls of the organ.There are many nerve endings in the bladder that respond to how full it is by sending signals to receptors in the brain. This message is identified by the body as a command to urinate, which leads to the contraction of the muscle layer and the release of urine through the ureters. With dysfunction of the bladder, this process becomes difficult, which is expressed in the inability of the organ to normally get rid of the accumulated fluid. The result of the violation is a gradual thickening of the muscular membrane of the walls.

Diffuse changes occur for the following reasons:

Urolithiasis, in which there is a risk of a stone entering the ureter, which becomes the basis for fluid accumulation and an increase in internal pressure.
A formation has formed in the neck of the bladder that prevents the outflow of urine.
In men, the walls of the organ become thicker against the background of pathological abnormalities of the prostate gland, including obstruction. A detailed examination of the prostate is required.
Women are much more susceptible to the development of changes in the structure of the bladder due to anatomical features. The proximity of the urethra to the anus and vagina increases the risk of infection and inflammation. Such circumstances create ideal conditions for the onset of cystitis, which can also lead to thickening if left untreated.
The presence of congenital or acquired stenosis of the bladder neck.
Formation of diffuse thickening against the background of urethritis.This disease is characterized by chronic inflammation of the walls of the urethra.
Congenital and acquired enlargement of the calyx and renal pelvis, called hydronephrosis. It is required to examine the ureters and kidneys;
Diverticulum in the bladder (bag-like protrusions). Emptying is carried out in stages – initially, fluid is released directly from the organ, and then stagnant urine from the diverticulum.
As a consequence of schistosomiasis.

Local thickening in the walls of the bladder does not affect the entire area of the organ, as in diffuse changes, but only a specific area.Such a deviation is characterized by an almost asymptomatic course, so the person does not suspect anything for a long time. Only qualified examinations and preventive examinations will help to recognize the changes that have begun in time.

A local process has an inherited or acquired nature. The main causes leading to pathology:

the presence of congenital features in the structure of the bladder;
the formation of malignant tumors, polyps affecting the walls of the membrane, papillomas, stones;
complication of schistosomiasis;
against the background of tuberculosis of the bladder with the formation of granulomas, it is they that provoke multiple local deviations in the walls;
mechanical trauma to the abdomen, provoking a hematoma on the bladder;

90,025 women are faced with local thickening due to current or past inflammation, infection of the urogenital organs, irregular sexual activity.

Treatment principles

The tactics and treatment regimen for the thickened bladder walls are determined by the reasons that caused the development of the pathological process. General measures are aimed at treating concomitant urological abnormalities, normalizing the structure of the walls, eliminating inflammatory foci and infections, therefore, antibacterial drugs from the group of a wide spectrum of action and other agents are prescribed. As a rule, treatment is carried out:

Atropine;
Papaverine;
Nitrite;
Amisil;
Eufilin;
Cholenzime;
Nicodemus;
Alloholom;
Oxafenamide.

If the changes are due to problems with the prostate gland, then the man, in addition to antibiotics, is additionally prescribed physiotherapy, prostate massage, and taking immunostimulants.When treating the bladder against the background of hyperplasia, a woman needs to combine therapy with hormonal drugs. In cases where the endometrium grows significantly or there are regular relapses, they resort to surgical intervention.

In conclusion, I would like to summarize and emphasize that structural changes in the walls of the bladder are just a clinical manifestation, and not an independent disease. This condition signals a malfunction in the organs of the urinary system, therefore, treatment should be comprehensive and primarily aimed at combating the main urological problem.A more attentive attitude to one’s own health, routine examinations by a doctor, and timely treatment of chronic inflammatory processes will help prevent such complications.

Thickening of the bladder wall

What is the thickening of the bladder wall?
Causes of the appearance of thickening of the walls of the bladder
Related Videos

With various diseases of the urinary system, thickening of the walls of the bladder can be observed.This pathology is rather unpleasant and requires immediate treatment.

As a rule, it can be determined using ultrasound. Based on its results, the doctor makes appropriate recommendations, prescribes a course of therapy.

What is the thickening of the bladder wall?

In order to timely start treatment, it is important to know what the symptoms of the disease are. The indications for the appointment of ultrasound and detailed examination are:

Pain in the lower abdomen and during urination.These are the main symptoms of cystitis, urolithiasis, which sometimes indicate the formation of tumors.
Hematuria is one of the most common pathologies. Urine with an ailment turns red due to the ingress of blood cells into it. The disease develops with urolithiasis, when the urinary tract suffers from stones and sand excreted from the body. Often, hematuria occurs with trauma to the organs of the urinary system.
Constant feeling of full bladder.

When passing urine tests, an increased content of leukocytes, the presence of proteins and bacteria are found.

In some cases, cystoscopy is required along with ultrasound to make a diagnosis. In doing so, you can check and inspect the structure of the inner surface of the bladder.

Thanks to such a procedure, it is possible to timely detect oncology, polyps and other serious diseases, which are often asymptomatic at the initial stage of development.

For research to give accurate results, experts recommend doing an ultrasound on a full bladder. In this case, the thickness of the walls will be determined accurately, the thickenings will be with clear boundaries, the localization is better visible.

Causes of the appearance of thickening of the walls of the bladder

Knowing the causes of the onset of the disease, you can prevent its development or stop it at an early stage. In men, the symptom of thickening is most often associated with obstruction of the ducts of the prostate gland.As a rule, this occurs with urolithiasis.

Hydronephrosis is a complex disease in which there is an expansion of the calyx and pelvis of the bladder. In this case, a thorough examination of the ureters and kidneys is recommended. This disease is characterized by progressive development.

In case of ailment, physiological changes in the bladder, such as diverticula, are observed. Such protrusions on the surface of the organ cause stagnation of urine, which, in turn, leads to inflammatory processes.

Chronic diseases are characterized by uneven thickening of the bladder walls. The presence of parasites causes the walls to thicken due to calcium deposits.
Polyps in the bladder range in size from a few millimeters to several centimeters. If present, the urine is usually bloody.

There can be a lot of reasons for the appearance of thickening of the walls of the bladder, since all organs and systems in the body are interconnected. Violations in one organ cause malfunctions in the other.Therefore, a thorough examination and observation of the patient is required to make a diagnosis.

As soon as the first symptoms of malaise appear, it is necessary to consult a specialist in order to prevent the development of the disease and its transition into a chronic form.

This disease is also observed in children. The most important thing is to notice the symptoms in a timely manner, since children themselves cannot explain what exactly worries them. At the same time, the child may not feel discomfort. It is especially important here to make a timely diagnosis and determine whether it is a congenital or acquired defect.

In young children, the appearance of a suspension is most often not a pathology, therefore, a more thorough examination is required to make a diagnosis here than with similar symptoms in adults.
The age of the patient is also important, since it determines how much fluid is considered the norm for filling the bladder.

Correct diagnosis is very important for prescribing treatment. Only then will it be effective and efficient.So, with urolithiasis, it is important to get rid of stones and sand. Here, the treatment depends on the size of the inclusions present.

Inflammatory processes resulting in a thickening of the bladder walls are treated with antibiotic therapy.

Tumors and polyps are mostly removed by surgery. Good results are shown by antibiotic therapy, coupled with physiotherapy, especially in the treatment of diseases of the urinary system in men.

All diseases can be prevented if you carefully monitor your health.So, it is worth revising your daily routine, changing your diet, giving up bad habits. Personal hygiene should not be neglected. When inflammatory processes occur, they need to be treated at the initial stage, and not when they flow into a chronic form. The most important thing is to regulate the metabolism.

Causes and treatment of thickening of the bladder walls

There are many diseases in which the bladder wall thickens. Such hypertrophy of the walls of the organ is the main symptom in the diagnosis of diseases of the genitourinary system.

Why does the bladder hardening occur?
Main symptoms
Local pathology
Hyperplasia
Symptoms of hyperplasia
How to identify a thickened bladder wall?
Treatment
Traditional medicine

The diagnosis of such diseases is difficult, but if you use ultrasound, the result can be obtained immediately for all patients, even for children. If an incorrect drug treatment regimen is not detected or prescribed in a timely manner, the disease turns into pathology, since most often the thickening of the bladder wall appears due to inflammation from infectious diseases.

Why is there hardening of the bladder?

Diffuse bladder thickening occurs in infectious diseases leading to dysfunction of the urinary system. This increases the load on the walls of the organ. They have nerve endings that send a signal of fullness to the central nervous system.

Main symptoms

Urolithiasis, leading to disorders of the genitourinary system. With a significant size of the stone, it blocks the pathways for urine output, accumulation of fluid and an increase in internal pressure occurs;
Neoplasm in the neck of the bladder, the narrowest point at which the urine outlet is blocked.Thickening of the walls of the bladder in men occurs due to the pathology of the prostate, which is accompanied by impaired deurination due to the pressure of the enlarged gland on the urethra. That is why male patients with malfunctions of the bladder need to do an examination of the prostate gland;
Features of the anatomical structure of the genitourinary system in women, consisting in a short and wide enough urethra, located close to the anus and vagina. The walls of the bladder thicken due to vulnerability to inflammatory diseases, and cystitis can also be the cause.A similar disease can occur in men, but much less often;
Narrowing at the junction of the urinary tract and bladder, called cervical stenosis. Stenosis can be either acquired due to previous diseases or congenital;
Lumps in the bladder are often caused by urethritis, in which they become inflamed in the urinary tract;
The presence of a diverticulum, a sac-like depression in the wall of the urethral canal. It is also possible to locate it in the cervical region, which interferes with natural urination.

Local pathology

The most common causes are as follows:

Peculiarities of the anatomical structure of the patient’s bladder;

90,025 polyps, papillomas, neoplasms, both malignant and benign, as well as stones;

dysfunction of the bladder of nervous etiology;
condition of schistosomiasis due to parasite infestation;
tuberculosis of the bladder;
injury and damage to internal organs;

90,025 in women with inflammatory processes, as well as irregular sexual activity or infection of the external genital organs.

Hyperplasia

Symptoms of hyperplasia

Thickening of the walls of the bladder with hyperplasia in men is characterized by the following symptoms:

No.	Useful information
1	Frequent deurination and polyuria and frequent urination
2	nocturia, in which a significant amount of fluid is released at night, significantly exceeding the daytime
3	feeling of incomplete urination and not emptying the bladder
4	urination in the form of drops at the end of deurination
5	Sexual Disorders
6	Intermittent stream of urine with weak pressure and the need to push.Painful sensations are also possible

In women, symptoms include an irregular menstrual cycle, acute pain and massive bleeding. In some cases, amenorrhea occurs when menstruation is absent for six months or more.

How to identify thickening of the walls in the bladder?

To find out the nuances, it is necessary to undergo an X-ray examination, which will reveal the degree of damage to the walls. You can also use cystoscopy, which examines the organ from the inside, showing uneven surfaces in the mucosa, both front and back.With cystoscopy, it is often possible to determine the presence of a tumor and the extent of its spread, as well as other abnormalities.

Treatment

In the treatment of male prostatitis, therapy should be comprehensive, including physiotherapy, prostate massage and correction of immunity. In women, hyperplasia is treated with drugs containing hormonal substances, but if there is endometriosis or its relapses, surgery is necessary.For each patient, treatment is prescribed individually, based on the history and complexity of the disease.

Traditional medicine

Traditional medicine with its plant substances can not only remove the seal of the walls in the organ, but also get rid of neoplasms and tumors with regular intake of phyto-drugs. Each of the recipes is useful, but you must first check the body for allergic reactions to plants.

Patients are recommended herbal teas from dandelion leaves, toadflax, mint, flowers and leaves of tansy, cinquefoil roots.Also useful will be tinctures of carrots, black radish, beets, aloe, vodka and honey.

The most popular folk remedy is ordinary millet, half a glass of which is washed and left in half a liter of clean hot water. After 15-15 minutes, shake the infusion and drink 150 ml up to five times a day for 15 days. Taking this remedy will reduce pain and cleanse the urinary ducts. Porridge made from this grain is also useful in any form.

Corn silk in the form of a decoction can relieve inflammation and reduce the intensity of pain.To do this, pour a tablespoon of the dry mixture with cold water, at least three glasses.

Diffuse thickening of the bladder wall: The request could not be satisfied

Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

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Comparison of Bladder Wall Thickening and Presence of Internal Echoes Within the Bladder for the Diagnosis of Cystitis in Infants | Iranian Journal of Pediatrics

Types of bladder wall hypertrophy

Causes of pathology

Features of the local form

Manifestations

Diagnostics

Treatment of thickening of the bladder wall

Prevention

Thickening of the walls of the bladder: causes, treatment of women, men and children

Why does the bladder hardening occur?

Main symptoms

Local pathology

Hyperplasia

Symptoms of hyperplasia

How to identify a thickened bladder wall?

Treatment

Traditional medicine

Thickening of the bladder wall – Healthy family

Varieties of pathology

Diffuse type of disease

Local type of disease

The main causes of pathology

Features of the seal

Clinical manifestations of the disease

How is pathology therapy carried out?

Preventive measures

Thickening of the walls of the bladder: what is it, symptoms, causes, treatment, prevention

What is

Classification

Reasons

Symptoms

Diagnostics

Treatment

Complications

Forecast

Prevention

Thickening of the walls of the bladder

ultrasound of the bladder

causes, treatment, symptoms in men and women

Signs of the disease

Which leads to diffuse and local changes

Principles of treatment

Possible causes and features of therapy

Complaints

Signs