Bladder diseases

Cysto-genital syndrome - symptoms caused by a disorder of the storage (reservoir) and excretory (evacuation) functions, which are caused by diseases of the urinary bladder or injuries, pathologies of the genitourinary and urinary systems, as well as innervation in case of damage to the membranes of the spinal cord (Brown-Sequard symptom).

Given the close anatomical and functional connection with the kidneys, internal and external genital organs, pathology in any part of the urinary or reproductive system ultimately leads to a disruption of the urination function. Reflex urges to urinate are normally formed when urine accumulates from 200 to 400 ml, i.e. when creating a pressure in the cavity of 10-15 cm of water in a vertical position or 30 cm of water in a horizontal position.

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Injuries

Damage can be closed (ruptures, more often occurring with pelvic fractures), extraperitoneal with the formation of leaks, or intraperitoneal with the development of peritonitis. They are often combined with damage to the rectum or vagina. Penetrating (open) injuries are much less common - both gunshot and inflicted with a cold weapon. Even if suspected, the victim should be hospitalized in a surgical or urological department, where a set of additional studies will be carried out. A special place is occupied by foreign bodies that get into it mainly during urethral masturbation, which proceed unnoticed, but over time lead to the development of stone formation and, as a rule, are a clinical finding.

Neurogenic diseases of the bladder

They develop with damage to the nerve pathways and centers that provide innervation and the function of voluntary urination. In case of pathology of the cortical, spinal ganglia and pathways responsible for innervation, its subordination with the spinal or cortical centers is disrupted, part or all of the links in the reflex chain of the act of urination are lost. In this case, the storage function may be disrupted, which leads to the development of urinary incontinence, or the evacuation function with the formation of urinary retention. Rarely, a mixed form of bladder disease develops, when there is urinary incontinence and its retention (residual urine). In children, and sometimes in adults, due to deep inhibition of the cortical centers during sleep or impaired reflexes, "nocturnal enuresis" occurs. A urologist or a surgical diagnostician must conduct a complete urological examination to exclude organic pathology, and the diagnosis and treatment of neurogenic disorders should be carried out by a neurologist.

Inflammatory diseases of the bladder

Cystitis is divided into non-specific and specific; acute and chronic. The spread of infection can be ascending or descending. All of them have the same clinical picture: frequent and painful urination; pain in the lower abdomen, urethra, especially during urination; cramping or constant pain in the epigastric region. Urine analysis is characteristic of all pathologies of the urinary system: urine is cloudy, protein may be slightly elevated, the reaction is often alkaline; leukocytosis, microhematuria, often a large amount of desquamated squamous epithelium in the sediment, but this can also be observed in urethritis.

Specific diseases of the urinary bladder (tuberculosis, syphilitic, gonorrheal, trichomonas, chlamydosis, etc.) in most cases are combined with damage to other parts of the genitourinary system. They are detected by bacteriological examination of urine, urethral contents, prostate juice and by a characteristic cystoscopic picture, as well as by serological and immune reactions.

A special place is occupied by calculous diseases of the urinary bladder. Stone formation can occur around foreign bodies, some parasites (schistomas), and kidney stones that have passed. Stones can be mobile or fixed. Characteristic: pain that appears or intensifies when walking and riding unevenly with irradiation to the perineum, testicles, and head of the penis; impaired urination (jamming, change in stream when standing and lying down, etc.); change in the nature of urine (mainly hematuria, but there may also be pyuria, high salt content).

Tumor diseases of the bladder

Benign tumors are very rare, do not have a characteristic clinical picture; and in most cases are a cystoscopic finding with concomitant cystitis. Malignant tumors develop predominantly (4 times more often) in men, especially in workers in the aniline, rubber and oil industries. Aniline cancer belongs to the group of professional cancers, and it is not aniline itself that has carcinogenic properties, but its derivatives, which are excreted from the body by the kidneys.

Characteristic symptoms are macrohematuria, dysuria (frequent urination in small portions), and leukocyturia is added in case of concomitant infections. The main diagnostic method is cystoscopy.

Malformations and degenerative diseases of the bladder

Diverticula, hernias, leukoplakia, malakoplakia, endometriosis are more common in women and are characterized by the development of persistent cystitis. The main diagnostic method is cystoscopy.