Bladder leukoplakia

The genitourinary system is one of the most vulnerable in the human body. In addition to cystitis and other inflammatory diseases, painful structural processes can also develop - for example, leukoplakia of the bladder. We are talking about pathological keratinization of the organ epithelium - that is, about the transformation of the transitional epithelial tissue into a flat one. As a result, keratinization foci appear on the mucous tissues, which do not perform the necessary protective function, which soon leads to the development of chronic inflammation of the bladder.

Leukoplakia is often mistaken for cystitis, which, however, does not respond to conventional treatment. Adequate therapy can be prescribed only after a competently conducted diagnosis confirming the insidious disease. [1]

Epidemiology

Chronic inflammatory processes in the lower segment of the urinary tract in female patients are very common. They are the most common reason for women to visit a urologist, gynecologist and therapist.

Disorders of urination annually "bring" about 3 million American women to the doctor. In the post-Soviet space, the incidence is estimated at about 15-20 thousand cases per 1 million patients. Every two women out of ten at least once in their life suffer from an inflammatory disease of the bladder, of which one woman suffers from a chronic form of inflammation.

For leukoplakia of the bladder, relapses are characteristic. It has been determined that every second woman after the inflammatory process subsides throughout the year has a repeated episode of the disease, and 50% of the exacerbation of cystitis occurs more than three times a year.

According to various sources, during cystoscopy in 64-100% of cases, accompanied by persistent urinary disorders and chronic pelvic pain, bladder leukoplakia is diagnosed. The most common localization of pathological foci is the neck of the organ and the urinary triangle.

Despite the prevalence of the disease, leukoplakia is still considered one of the most poorly studied pathologies of the mucous tissue of the urea. [2]

Causes leukoplakia of the bladder

Despite numerous studies, the cause of bladder leukoplakia is still a mystery to scientists. The most common theory is that leukoplakia is a consequence of some intrauterine abnormalities. That is, even during intrauterine development, certain defective foci are formed in the walls of the urinary system. This theory is supported by the fact that the disease is most often found in persons suffering from disorders of the development of the urinary tract. In addition, risk factors, which we will describe a little later, also have some influence. The most common fact of infectious influence: cellular transformation begins to develop after an infectious pathology. [3]

The development of leukoplakia is provoked by such an infection:

• gonococcus;
• chlamydia;
• trichomonas;
• herpesvirus;
• papillomavirus.

Another infection can enter the bladder through blood and lymph flow:

• staphylococcus;
• streptococcus;
• Escherichia coli, etc.

Risk factors

The following factors increase the likelihood of developing leukoplakia of the bladder:

• endocrine pathologies affecting the function of the pituitary gland and hypothalamus, as well as paired female sex glands - ovaries. With an increase in estrogen levels, the epithelium becomes vulnerable and prone to transformation. In some patients, leukoplakia begins to develop after prolonged treatment with hormonal agents;
• inflammatory processes in the bladder, or in organs located in the immediate vicinity of it. Often leukoplakia develops against the background of chronic cystitis, urolithiasis, traumatic lesions of urea, penetration of foreign objects into its cavity;
• chronic pathological processes in the body - for example, chronic tonsillitis, dental caries, pyelonephritis, etc.;
• prolonged and strong drop in immune defense.

The start of bladder leukoplakia can occur against the background of promiscuous sexual intercourse without barrier protection, with frequent stress and hypothermia. [4]

Pathogenesis

If there are no problems with the bladder, then its epithelial layer will produce polymeric carbohydrate-protein complexes - mucopolysaccharides. Their purpose is to prevent the adhesion of microbial cells to the walls of the organ. Also, these complexes provide cellular protection against degradation by acids.

With a pathological transformation of the epithelium, such cellular protection ceases to be reliable, and pathogens almost freely penetrate into the cell structures. The patient develops a chronic inflammatory process. A kind of cyclicality appears: cystitis aggravates the course of leukoplakia, which, in turn, maintains the activity of the inflammatory reaction.

Microbial infection enters the urinary system mainly along the ascending path, namely from the surface of the external genital area. The infection can also be carried by blood or lymphatic fluid, but this is relatively rare. In this situation, bacteria can penetrate from organs such as the kidneys, lower digestive tract, uterus, etc. [5]

Epithelial transformation in the bladder triangle is within the normal range. A similar condition develops in women under the influence of estrogens. If these changes are not subject

Symptoms leukoplakia of the bladder

The basic symptoms of bladder leukoplakia are in many ways similar to the picture of acute cystitis. Patients note pain in the pubic area, frequent urge to urinate, cutting and burning sensations at the final stage of urination, discomfort during sexual intercourse. In the urine, you can visually detect light flakes and even blood threads.

The first signs of a problem:

• increased urge to empty the bladder;
• breaks in the stream during urination;
• discomfort, pain, other discomfort during the process of urination;
• uncomfortable feeling in the lower abdomen, stretching in the lumbar spine;
• deterioration in general health, apathy, disability;
• feeling of insufficient emptying of urea.

Urinary incontinence is a symptom that does not affect all patients. It is characteristic of the so-called cervical leukoplakia (when the focus is located in the neck of the bladder), or is found in the advanced form of this disease. Incontinence can be of varying degrees: in some patients it manifests itself against the background of the relative fullness of the bladder, while in others, leakage can be observed within 15-20 minutes after the organ is completely empty. [6]

These symptoms are non-specific and may indicate not only the presence of leukoplakia, but also an exacerbation of cystitis, or other problems with the urinary system. The final diagnosis will never be established only from the description of the clinical picture. A thorough diagnosis with cystoscopy and biopsy is required.

Leukoplakia of the bladder in women

Bladder leukoplakia can affect both female and male patients. However, women often have to deal with such a disease - primarily due to certain anatomical features.

The short urethral canal allows the infectious agent to easily enter the bladder of patients. A weakened immunity, stress in combination with other factors make it possible for the rapid development of pathological processes.

Most often, the infection enters the urinary tract ascending from the external genital area.

With leukoplakia of the bladder, the normal epithelial layer transforms into a flat one, with the formation of keratinized foci. The disease is diagnosed either by accident or with long-term and ineffective treatment of cystitis. In this case, a biopsy with subsequent histology of the selected materials becomes the basis for correct diagnosis.

In women, leukoplakia can affect not only the bladder, but also the cervix. This pathology occurs in many patients of childbearing age. The disease is usually chronic.

Bladder leukoplakia and pregnancy

With leukoplakia of the bladder, pregnancy can be significantly complicated - primarily due to the high likelihood of a relapse of the disease. With an exacerbation in the first trimester of pregnancy, there is a danger of spontaneous interruption of gestation, or the appearance of developmental defects of the unborn baby.

An exacerbation in the third trimester creates a threat of premature placental abruption, intrauterine infection of the fetus, premature birth.

With an exacerbation of leukoplakia during pregnancy, they try to postpone antibiotic therapy. However, with significant and intense symptoms, antibiotics are still prescribed. The full course of treatment is carried out after the birth of the child.

Patients suffering from leukoplakia should take measures to eliminate the disease even before pregnancy. Even if a woman suffers from frequent cystitis, chronic cystitis, she needs to undergo preventive treatment in advance. [7]

Stages

Bladder leukoplakia in its course goes through several stages, or stages:

1. Squamous cell transformation. This stage is characterized by the restructuring of the layer of transitional epithelial tissue into a stratified squamous epithelial tissue. As for the cells themselves, they do not change.
2. Squamous cell replacement. This stage is the first step towards cell death, as they gradually pathologically change in the degenerated multilayer tissue.
3. Formation of focal thickenings against the background of processes of cellular keratinization. [8]

With leukoplakia of the bladder, a number of sclerotic processes occur that affect the inner walls of the cavity. Over time, the organ can no longer contract adequately, which, in turn, leads to urinary incontinence. A similar complication is characteristic precisely for leukoplakia: with cystitis, such a symptom is not observed. [9]

Forms

There are three types of bladder leukoplakia:

• flat leukoplakia;
• warty leukoplakia with pronounced areas of keratinization;
• erosive leukoplakia with the presence of ulcerative lesions of the mucous tissue.

A flat form of leukoplakia is often almost asymptomatic, and only with large-sized foci is a characteristic clinical picture noted.

The warty and erosive type of pathology is accompanied by pronounced painful symptoms. The leukoplakia of the bladder neck is distinguished by especially intense symptoms: with the spread of the pathological process, the patient's condition deteriorates sharply, symptoms of acute cystitis appear. Medication therapy often provides no visible relief.

Complications and consequences

Even after a full course of treatment of bladder leukoplakia, the patient will have to systematically undergo preventive diagnostics - to prevent the recurrence of the disease, as well as to prevent complications such as:

• malignancy, the development of a malignant process in the walls of the bladder;
• violation of the normal function of the urinary system, loss of contractility of the bladder, leakage and urinary incontinence;
• failure of renal function with further disorder of water, electrolyte, nitrogenous and other types of metabolic processes;
• bleeding, hematuria.

Recurrence of bladder leukoplakia after drug treatment occurs quite often, since conservative treatment does not cure the disease forever. After more radical surgery, the disease recurs in about 7-12% of cases. It is assumed that the relapse may be due to incomplete excision of the pathological zone, because in some areas a deeper impact may be required. If such features are not taken into account, the prerequisites for incomplete removal of the pathology arise, which becomes the basis for the re-development of leukoplakia. The lowest number of relapses is observed after the radiofrequency excision procedure. [10]

Diagnostics leukoplakia of the bladder

The diagnosis of bladder leukoplakia cannot be established solely on the basis of patient complaints and the results of an objective examination. A comprehensive diagnosis is required with mandatory histological examination of tissue particles of the cavity organ.

A full range of examinations is something like this:

• Collection of anamnestic data (frequency and intensity of attacks, the presence of other pathologies and predisposing factors).
• Vaginal examination of women (necessary both for differential diagnosis and for assessing the general health of the patient's genital area).
• Laboratory tests: general analysis of blood, urinary fluid, examination of vaginal and urethral smears, blood biochemistry, assessment of the level of creatinine and urea, bacterial culture of urinary fluid.
• PCR and ELISA diagnostics for detecting latent infection.
• Instrumental diagnostics: ultrasound examination of the kidneys and organs located in the small pelvis, urodynamic diagnostic procedures (urometry, cystoscopy), endoscopy. [11]

Cystoscopy of the bladder is necessarily accompanied by a biopsy - a procedure for pinching tissue material for further histological examination. For leukoplakia, this method is considered the most informative, since it provides an opportunity to assess the nature of the disease, its form and degree of damage. During cystoscopy, leukoplakia foci have the appearance of flattened whitish zones, or small erosions, or yellowish plaques. [12]

To clarify the diagnosis of bladder leukoplakia, ultrasound is performed for all organs of the small pelvis, as well as for the kidneys. Such a study demonstrates the location, shape, structural features, size of the organs in question. During diagnostics, echo-positive formations can also be detected - for example, stones or tumor formations that can reflect the ultrasound flow.

To confirm the diagnosis of urinary bladder leukoplakia, histological detection of metaplastic transformations in cellular structures is important, even in cases where there is a clear endoscopic picture of the disease.

Differential diagnosis

Differential diagnosis is performed with squamous cell papilloma and, in some cases, with a malignant process in the bladder. Bladder leukoplakia and cancer can have similar symptoms, but competent diagnosis in the form of cytological analysis of urine and cystoscopy with biopsy usually clarifies the situation. The likelihood of carcinoma detection is facilitated by the cystoscopy procedure with blue light, after intracavitary instillation of hexylamine levulinate. Sometimes there is a need for additional biopsy, with the collection of muscle tissue.

Simultaneously with the defeat of the bladder in women, there may be leukoplakia of the cervix. However, a combination of these pathologies is rare and requires different diagnostic and therapeutic approaches.

Treatment leukoplakia of the bladder

The possibility of treating leukoplakia without the help of a surgeon is assessed by a doctor after making an accurate diagnosis, determining the degree of complexity of the pathology. The conservative method involves the use of a drug effect on the infectious component of the disease.

To do this, you must use the following drugs:

• antimicrobial drugs to destroy pathogenic flora;
• anti-inflammatory drugs;
• means for strengthening the immune system;
• multivitamin preparations.

To restore the walls of the bladder damaged by the pathological process, irrigation is used with special means, which are analogues of natural glycosaminoglycans. Thanks to such procedures, it is possible to restore the damaged tissue.

Physiotherapy and diet therapy are appropriate as an adjunct to treatment.

Surgical treatment is resorted to if conservative therapy does not bring the desired positive result. [13]

Medicines that a doctor may prescribe

In an infectious process, the appointment of specific drugs that act directly on the pathogen is required. Preliminary analysis of urinary fluid with bacteriological examination, assessment of the sensitivity of pathogenic flora to antibiotics is carried out.

Trichomonas cystitis requires the appointment of Macmiror, Metronidazole, Furamag.

In case of fungal inflammation, Pimafucin, Intraconazole, Fluconazole are prescribed.

For the treatment of herpes, cytomegalovirus, Acyclovir, interferons are used.

A course of immunostimulants is required - for example, tinctures of echinacea, Cycloferon.

Against the background of antibiotic therapy, Bifidumbacterin, Lactobacterin are used to support the immune system.

Useful drugs Kanefron or Nefrosten, which are taken in a long course.

Monurel	Cranberry extract, the so-called natural antimicrobial drug. Take once a day, before going to bed: dissolve 1 package of granules in 100 ml of water. Possible side effects: diarrhea, heartburn, skin rashes.
Kanephron	A herbal preparation, an active diuretic with analgesic and antimicrobial effects. Enhances the effectiveness of antibiotic therapy. Take 2 tablets (or 50 drops) three times a day, with a sufficient amount of liquid. During treatment, nausea, diarrhea, and allergic reactions may occur.
Urolesan	Herbal remedy with antispasmodic, anti-inflammatory, analgesic and antimicrobial action. The drug eliminates pain and normalizes urination. Urolesan is taken orally with food, 1 capsule three times a day, up to one month (the drug can also be taken in the form of drops or syrup). Side effects: dyspepsia, allergic manifestations, dizziness, changes in blood pressure.
Nevigramon	Uroseptic, whose action is based on the presence of nalidixic acid. The drug is taken at 1 g 4 times a day for a week (the dosage can be adjusted by the attending physician). The most likely side effects: dyspepsia, cholestasis, headache, visual impairment, allergies.
Nolitsin	A broad spectrum antibacterial agent, second generation fluoroquinolone. The tablets are taken between meals, with plenty of water (to ensure the stability of urine output). The dosage and frequency of admission are selected individually. Possible side effects: heartburn, nausea, jaundice, increased anxiety, arrhythmia, hypotension.

Kanephron with leukoplakia of the bladder

Canephron is most often prescribed for the treatment of cystitis and pyelonephritis, but this drug is also appropriate for bladder leukoplakia. What is it for?

Kanefron successfully copes with bacterial infection, accelerates the excretion of fluids and salts from the body, and protects the tissues of the urinary system from damage. If the patient is to undergo surgical removal of leukoplakia foci, then Kanefron is indispensable here either: the drug will help stop the inflammatory process and prepare the patient for surgery.

Typically, for leukoplakia of the bladder, Canephron is taken either in drops (50 drops three times a day), or in tablets (2 tablets three times a day). Duration of admission is 2-3 months, sometimes more, at the discretion of the doctor.

This treatment is supplemented with the use of medicinal urological collection, drinks based on cranberries, rose hips.

Vitamins

For the treatment and prevention of exacerbations of leukoplakia of the bladder, most doctors advise taking measures to strengthen the body's defenses and increase resistance to infections. For all patients, multivitamin complexes with minerals become a good addition to treatment.

High-quality complex and biologically active preparations can be found in most pharmacies. And the attending physician will help you choose the necessary optimal variant of vitamins, for example:

• Solgar, Natural Cranberry with Vitamin C, Natural Cranberry with Vitamin C;
• Nefrocaps, Elite-Farm;
• Cystymine, Vivasan;
• Uva Ursi, Natures Way, Bearberry;
• Vitamax, Aloe Cranberry Concentrate, Aloe and Cranberry Juice Concentrate;
• GoLess, Country Life, Bladder Health;
• D-Formula, Altera Holding;
• Rensept, Art Life.

Taking vitamin preparations is usually long-term. Dosage - according to the instructions for a specific complex product.

Physiotherapy treatment

For the treatment of leukoplakia of the bladder, physiotherapy methods are often used:

• laser treatment combined with short-pulse electroanalgesia;
• laser treatment with magnetotherapy;
• short-pulse electroanalgesia with magnetotherapy;
• Microwave therapy;
• ultra high frequency therapy;
• exposure to sinusoidal modulated currents;
• endovesical phonophoresis.

In the process of physiotherapeutic treatment, it is recommended to supplement the use of sinusoidal modulated currents with electrophoresis. Thanks to this combination, it is possible to block the disturbed impulse from the organ damaged by the disease.

The use of warming procedures for bladder leukoplakia is impractical. Moreover, home thermal procedures (baths, heating pads, etc.) provide optimal conditions for the rapid multiplication of infection.

Ozone therapy for urinary bladder leukoplakia

For some patients with bladder leukoplakia, complex therapy is used with the intake of Tamsulosin, 0.4 mg in the morning and intravenous administration of ozonized saline with an ozone concentration of 6 mg / liter. The ozone therapy course consists of five daily intravenous injections, after which they pause for one day and carry out the five-day course again. The duration of each infusion is from half an hour to fifty minutes.

The criterion for the effectiveness of ozone therapy is the stabilization of the urinary process, the disappearance of the clinical symptoms of the disease, the improvement of laboratory and functional parameters. As a rule, the first signs of improvement are observed after 1-2 procedures.

Ozone therapy is not accompanied by negative side effects and allergic processes. The technique is quite simple and accessible, it can be used both in a hospital setting and on an outpatient basis.

Alternative treatment

Unfortunately, alternative recipes are not able to completely cure a person from bladder leukoplakia. However, they can act as an additional factor in the complex treatment prescribed by the doctor.

• They drink freshly squeezed carrot and beet juice instead of tea.
• Gauze napkins dipped in rosehip and sea buckthorn oil are applied to the external genital organs.
• Propolis is chewed several times a day.
• In the evenings, the external genitals are treated with goose fat, coconut or palm oil.
• Drink daily 250 ml of fresh milk with soda dissolved in it (1/2 tsp).

A good effect is also found when using natural herbal preparations prepared on the basis of medicinal herbs.

Herbal treatment

• Every morning they drink a glass of broth of young fir needles (1 tbsp. L. Raw material for 250 ml of boiling water). With good tolerance, the broth can be used more often - for example, twice or three times a day.
• Take the hemlock infusion: 100 g of plant inflorescences are poured with 0.5 liters of vodka, kept for three weeks in a cool place. Filter and start treatment. On the first day, 1 drop of the tincture is drunk with 100 ml of water. Every day, the number of drops is increased by one, bringing to 40 drops per day.
• They are washed daily with chamomile infusion (1 tsp per 200 ml of water).
• Take a pharmacy tincture of ginseng - three times a day, 1 tsp, for a couple of weeks.

Remember: any alternative treatment must be agreed with your healthcare professional!

Homeopathy

Homeopathic treatment is always prescribed against the background of conservative therapy: the combination of methods is discussed personally with the attending physician. Since leukoplakia of the bladder is a rather serious pathology, it is very important that the treatment is competent and conditioned: the choice of a homeopathic drug should remain with an experienced and knowledgeable specialist who is familiar with all the details of a particular disease and has all the necessary information about the patient.

It should be borne in mind that at the very beginning of homeopathic treatment, depending on the prescription regimen, the onset of the so-called "primary deterioration" is possible. Its duration and severity are always different, and it is impossible to guess them. However, within a few days the condition should return to normal.

In the complex therapy of patients suffering from leukoplakia of the bladder, it is possible to use such homeopathic preparations in individually selected dosages:

• Aktea rasemos (raven black);
• Causticum;
• Agaricus muscarius (fly agaric);
• Cocculus indicus (kukolvan);
• Conium waste (hemlock);
• Kalium carbonicum;
• Kalium phosphoricum;
• Lachesis (rattlesnake);
• Plantago major (large plantain);
• Rumex crispus (curled sorrel);
• Staphisagria.

It is also allowed to use the combined preparations Berberis homaccord, Belladonna homaccord, Populus compositum, etc.

The funds are selected, both in accordance with the prevailing symptoms of bladder leukoplakia, and taking into account the constitutional characteristics of the patient.

Surgery

If drug treatment does not lead to the desired result, then the doctor suggests that the patient take the help of a surgeon. Indications for surgical intervention are:

• persistent inflammatory process, proceeding with impaired urinary contraction function;
• leukoplakia of the second or third degree, confirmed by histology;
• intense pain syndrome, not eliminated by medication;
• diagnostically confirmed presence of atypical cellular structures, which is a sign of a precancerous condition.

With leukoplakia of the bladder, the doctor may consider the following options for surgical treatment:

• TUR is an operation of transurethral resection of the urea. The intervention involves the removal of pathologically altered areas of mucous tissue using a special loop tool. The loop is inserted into the urethral canal using endoscopy. This procedure is gentle and does not imply violation of the integrity of the organ.
• Cauterization of urinary bladder leukoplakia is carried out by the method of thermal action of high-frequency current supplied to the tissues with the help of directed ionized argon plasma. The intervention device consists of an argon gas source and a high frequency current source. Coagulation of tissues occurs by heating them. The depth of the impact depends on its duration, on the hardware settings and the power set. The method allows not only to remove pathological foci, but also to neutralize the pathogenic flora in the subepithelial layer.
• Laser coagulation of urinary bladder leukoplakia leads to the formation of a clearly limited homogeneous area of carbonization: radiation is absorbed in full, causing a point evaporation of the tissue. The depth of the "work" of the laser is insignificant against the background of a strong hemostatic effect, which is a positive moment when performing an operation on the urinary tissues saturated with blood vessels. Laser coagulation is considered one of the highly effective treatments for leukoplakia. The undoubted advantages are minimal invasiveness, a good degree of hemostasis, almost complete absence of operational complications, and the minimum possible hospital stay. The rehabilitation period is short: the urinary mucosa is completely cleared of the scab within 3-4 weeks.
• Laser ablation of bladder leukoplakia involves the use of a laser pulse, which provides high-quality hemostasis, minimal surgical trauma, no postoperative complications, and a short recovery period. Removal of bladder leukoplakia occurs in two main stages:
  • penetration with the help of special instruments into the urethra;
  • performing the operation by evaporation. [14]

During the operation, the surgeon can control the entire process by changing the wavelength, duration and frequency of impulses.

• Plasmokinetic vaporization of urinary bladder leukoplakia helps to achieve complete devitalization of the damaged layer of the bladder, with minimal impact on the surrounding and underlying tissues. The postoperative period, which includes antibiotic therapy, ensures the eradication of bacteria and inhibits the development of a new wave of the inflammatory process. The inclusion of glycosaminoglycan analogs in the therapeutic regimen contributes to the creation of a protective membrane over the operated area: this prevents the adhesion of uropathogens and prevents the penetration of urinary particles into the mucous membrane. This fact significantly speeds up the regeneration process.

The postoperative period after surgery is usually relatively short: a course of antibiotics and other supportive and restorative drugs is prescribed:

• The drug Vesikar after TUR of leukoplakia of the bladder is prescribed to prevent the development of bladder hyperactivity syndrome. Vesicar belongs to m-anticholinergics, it is taken at 5 mg daily for 2-3 months. Additionally, it is possible to connect the drug Tamsulosin, as well as physical procedures.
• Oral contraceptives, including drugs with antiandrogenic action, are not recommended to be taken with histologically confirmed leukoplakia. However, the same drugs - for example, Jess after a tour of bladder leukoplakia is allowed to be taken after 3-4 months, in the absence of a relapse of the disease. Hormone replacement therapy is appropriate during menopause - to improve the condition of the mucous tissue.
• Antibiotics and anti-inflammatory drugs are prescribed both to prevent the development of the inflammatory process and to accelerate tissue repair. For example, acute uncomplicated microbial cystitis is most often provoked by bacteria such as Escherichia coli, enterococci, Klebsiella, Proteus. Sometimes the same Klebsiella is found after a tour of bladder leukoplakia, which may require a repeated course of antimicrobial drugs.

Diet for leukoplakia of the bladder

To get rid of bladder leukoplakia in the shortest possible time, in addition to treatment, you need to adjust your diet. Dishes and the products included in them should be chosen according to the principle of their mild effect on the digestive organs. It is preferable to cook in a double boiler, boil or bake food.

Products recommended for patients with bladder leukoplakia:

• fresh fruits;
• fresh and boiled vegetables (except cabbage, tomatoes, onions and garlic, radishes);
• not too fatty fish, white meat;
• fermented milk products;
• cereals.

You need to drink about two liters of water per day. This is necessary for the natural flushing of the bladder and to reduce the concentration of uric acid, which irritates the mucous membrane of the organ. In addition to ordinary clean water, it is recommended to drink herbal infusions, unsweetened green tea, berry-based compotes, cranberry jelly.

The following products fall under the ban:

• spices, seasonings, hot peppers, mustard, horseradish;
• alcoholic drinks;
• marinades, salt;
• fish, meat broths;
• smoked and fried foods;
• strong coffee, strong black tea, carbonated drinks;
• chips, snacks, croutons, etc.

The diet is based on this principle: food should be as natural as possible, without chemical additives, without spices, with the minimum possible amount of salt (or better, without it at all). The fewer irritating factors present in food, the sooner the long-awaited recovery will come.

Prevention

Preventive measures include the prevention of sexually transmitted diseases, hormonal disorders, infectious processes throughout the body. It is important to promptly heal metabolic disorders, infectious and inflammatory diseases.

It is advisable to completely quit smoking, limit the use of alcoholic beverages, hot seasonings and spices.

All these measures must be combined with careful observance of the rules of personal and intimate hygiene. For a long time, it is necessary to carry out vitamin therapy, which includes B vitamins, vitamin A, calcium, coenzymes.

You should pay special attention to the condition and strengthening of the immune defense. To maintain the required level of immunity, it is necessary to eat properly and fully, lead an active lifestyle, often be in the fresh air, and avoid stress.

The bladder area should be protected from injury, and it is best to seek medical attention as soon as possible for any suspicious symptoms.

Forecast

The prognosis for leukoplakia of the bladder can become favorable, provided that timely competent treatment should be carried out until irreversible violations begin to occur in the walls of the organ. The most favorable outcome is expected if the patient underwent endoscopic intervention with resection of the affected areas of the epithelium. However, no doctor can guarantee one hundred percent that the disease will never remind of itself with a relapse. Repeated development of leukoplakia is often noted, which requires a new course of treatment.

With the intensive progression of the disease, which is accompanied by wrinkling of the urinary organ, loss of elasticity, the quality of the prognosis becomes difficult to determine. The patient is prescribed long-term supportive treatment to normalize his health. If such treatment is not carried out, then there are great risks that leukoplakia of the bladder will be complicated by failure of renal function. And this can already lead to death.