Bladder leukoplakia
Bladder leukoplakia is a chronic disease in which the cells of the transitional epithelium lining the bladder cavity are replaced by squamous epithelial cells.
There are areas covered with keratinizing epithelium, which, unlike the transitional one, does not protect the walls of the bladder from the active influence of urine components, which causes chronic inflammation.
The disease occurs in women much more often than in men, due to the structural features of the female urethra, which makes the bladder more accessible to infection, which, as it turned out, plays a leading role in the occurrence of bladder leukoplakia.
Causes of bladder leukoplakia
The main route of infection in the bladder is ascending, i.e. from the external genital organs. Most often, leukoplakia of the urinary bladder is caused by sexually transmitted infections (STIs) - ureaplasma, mycoplasma, Trichomonas, gonococcus, chlamydia, herpes virus. However, a descending route of infection is also possible, when the infection enters the bladder with the flow of blood or lymph from the kidney, intestines, uterus and its appendages. In this case, the pathogens are Escherichia coli, streptococci, staphylococci, proteas, etc.
Factors predisposing to bladder leukoplakia disease are:
- Chronic diseases of neighboring organs;
- Removed foci of chronic infection (carious teeth, chronic sinusitis, tonsillitis, etc.);
- Long-term, exceeding the permissible terms, the use of an intrauterine device;
- Anomalies in the structure of the organs of the genitourinary system;
- Disordered sex life, without the use of barrier contraception;
- Endocrine diseases;
- Hypothermia, hectic lifestyle, stress, insufficient rest - all those factors that reduce immunity.
Bladder leukoplakia symptoms
The main symptoms of bladder leukoplakia, with complaints of which patients go to the doctor, are pain in the pelvic region (chronic pelvic pain) and urinary disorders. These symptoms can have varying degrees of severity, most clearly they are manifested in leukoplakia of the bladder neck - an area more susceptible to the appearance of this pathology. The pain in this disease is dull, aching, and may be constant. Patients feel discomfort in the bladder area. With leukoplakia of the bladder neck, urination causes cutting pain or burning.
With an exacerbation of inflammation, symptoms of cystitis join the symptoms of leukoplakia of the bladder: frequent urination, intermittent stream, incomplete emptying of the bladder during urination, painful urination increases, and the general condition worsens.
In general, the symptoms of bladder leukoplakia are very similar to those of cystitis, which is often the cause of diagnostic errors and treatment failure. As a result of studies carried out by urologists, it was found that most of the women who had been unsuccessfully treated for a long time from chronic cystitis and experienced constant pelvic pain syndrome, in fact, suffered from leukoplakia of the bladder neck, which was found out after conducting a thorough extended diagnosis.
Diagnostics of the leukoplakia of the bladder
To establish the diagnosis of bladder leukoplakia, the following studies are used:
- General, biochemical, bacteriological analyzes of urine;
- Functional urine test according to Nechiporenko;
- All types of analyzes for the presence of STIs (bacterial culture, PIF, PCR);
- Gynecological examination of the patient with the obligatory taking for the analysis of vaginal contents;
- Immunogram;
- Ultrasound of the pelvic organs;
- Cystoscopy:
- Biopsy of the bladder wall.
When conducting studies aimed at detecting STIs, it should be borne in mind that during the period of remission of the symptoms of bladder leukoplakia, tests may not show the presence of infection. Research in this case must be repeated during an exacerbation of the disease, or after a provocation.
Cystoscopy is the main method in the diagnosis of bladder leukoplakia, allowing to differentiate this disease from chronic cystitis.
Bladder leukoplakia treatment
Depending on the stage of the process and the extent of the lesion, a method for treating leukoplakia of the bladder is chosen. The disease is treated with medication and surgery.
Therapeutic treatment of bladder leukoplakia consists of the appointment of several groups of drugs, with the aim of a complex effect on the pathogen and the tissue areas affected by it. Antibacterial drugs are used that affect the identified microflora, anti-inflammatory, fortifying agents, and immunocorrectors. In order to protect the damaged bladder wall from the aggressive effects of urine, instillation (irrigation) of the bladder is used with drugs that are analogs of natural glycosaminoglycans (hyaluronic acid, heparin, chondroitin, etc.) - substances that restore the damaged layer of the epithelium.
Physiotherapeutic treatment of urinary bladder leukoplakia is widely used: electrophoresis of medicinal substances, laser therapy, magnetotherapy, microwave exposure, i.e. all those methods that help relieve inflammation, nourish and regenerate tissues, eliminate the adhesions that often accompany chronic inflammation.
In case of failure of therapeutic methods or an advanced stage of the disease, they resort to surgical operation of leukoplakia of the bladder. This is an extreme measure, but sometimes it is the only effective way to treat the disease. In case of leukoplakia of the urinary bladder, the operation is called TUR - transurethral resection of the bladder. This is an endoscopic operation performed using a cystoscope, which is inserted through the urethra into the bladder, where the affected tissue is cut using a special loop. The cystoscope is equipped with a fiber-optic light source and a camera, due to which the operation of leukoplakia of the bladder is carried out under the control of vision, and it becomes possible to completely remove the damaged parts of the organ while maintaining its integrity.
Complications of urinary bladder leukoplakia
The danger of bladder leukoplakia, in addition to the inconvenience caused, is that the wall of the bladder, as a result of prolonged inflammation, becomes sclerosed, loses its elasticity, due to which the bladder becomes incompatible and actually loses its function, since urinary retention occurs only for a 20-30 minutes, after which it starts to leak. Renal failure gradually develops, leading to death.
Bladder leukoplakia is also a precancerous condition, which means that in the absence of quality treatment, it can degenerate into cancer.
With this in mind, treatment of bladder leukoplakia should be adequate and urgent.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
