What Is Cystitis Glandularis?
Glandular cystitis is a relatively rare non-tumor inflammatory lesion. It is a lesion that coexists with epithelial hyperplasia and metaplasia. The process is that the epithelial hyperplasia is recessed into a Brunn nest, and cracks appear in it, forming branch-like, Glandular metaplasia appears in the center of the circular lumen to form a glandular structure. At the same time, there is infiltration of lymphocytes and plasma cells, so it is called glandular cystitis. It has special pathological development process and clinical onset characteristics. The etiology of glandular cystitis is still unclear, and may be related to chronic bladder inflammation, stones, obstruction, neurogenic bladder, and eversion of the bladder. It is more likely to occur in the bladder triangle, the neck of the bladder, and around the ureteral orifice. According to the morphology of cystoscope, glandular cystitis is divided into the following papilloma-like, follicular or villous edema, and chronic inflammatory There are 4 types of reactive type and mucosa without significant change.
Basic Information
- English name
- glandular cystitis
- Visiting department
- Urology
- Common locations
- bladder
- Common causes
- Chronic bladder inflammation, stones, obstruction, neurogenic bladder, bladder eversion, etc.
- Common symptoms
- Recurrent, refractory urinary frequency, urgency, dysuria, hematuria, discomfort in the upper pubic area and perineum, feeling of bloating in the lower abdomen, urinary incontinence, pain during intercourse, etc.
Clinical manifestations of glandular cystitis
- Mainly manifested as a series of recurrent, refractory urinary frequency, urgency, dysuria, hematuria, discomfort in the upper pubic area and perineum, a feeling of bloating in the lower abdomen, urinary incontinence, and pain during intercourse. The most common lesions are the bladder triangle, the bladder neck, and the ureteral orifice. The neck orifice is more common at 3 to 9 o'clock. The clinical manifestations of glandular cystitis are closely related to the lesion location: those with lesions located in the triangular area mainly exhibit bladder irritation signs; those with bladder neck often have poor urination, lower abdominal discomfort, and severe cases with dysuria; the lesions involve ureteral opening Patients can cause symptoms of lumbar discomfort such as ureteral dilatation and hydronephrosis; hematuria is more common in patients with a wider range of lesions; urinary flow may be interrupted in patients with bladder stones.
Glandular cystitis examination
- Imaging is important, but it is generally believed that the diagnosis is mainly based on cystoscopy plus biopsy.
- Cystoscopy has the following characteristics:
- 1. The lesions are mainly located in the triangular area and the bladder neck;
- 2. The lesions are polycentric, often scattered, and exist in slices or clusters;
- 3. It has a variety of morphology, with nipple-like, lobulated, and follicular mixtures. The top of the tumor is almost transparent, and no blood vessels grow on it.
- 4. Most of the ureteral orifices are unclear.
Glandular cystitis diagnosis
- The diagnosis of glandular cystitis mainly depends on imaging and cystoscopy. The diagnosis requires the support of cystoscopy pathological biopsy. Imaging is important, but it is generally believed that the diagnosis is mainly based on cystoscopy plus biopsy.
Differential diagnosis of glandular cystitis
- The characteristics of this disease are easier to distinguish from typical bladder transitional cell carcinoma, but some cases are difficult to distinguish from follicular chronic cystitis and adenocarcinoma. A biopsy is required for a pathological diagnosis.
Glandular cystitis treatment
- The treatment of glandular cystitis is mainly drug treatment, surgical treatment, and a combination of the two. Surgical treatment can use intraluminal or open surgery. Drug treatment is intravesical infusion.
- Treatment of glandular cystitis:
- 1. Take appropriate treatment after removing chronic stimuli such as infection, obstruction and stones
- Firstly, the chronic stimuli such as infection, obstruction and stones need to be removed, and then corresponding treatment should be taken according to the type, location and scope of the lesion. For example, under the premise of bladder outlet obstruction, transurethral electrocautery, resection and bladder perfusion. Because of the recurrence of glandular cystitis, transurethral electrocautery or resection is less invasive to the patient, which can be repeated. It can be used as the preferred treatment method for glandular cystitis. Regarding the timing of electrocautery or resection, it is best to perform the surgery safely and effectively after the urine is normal, and it is not easy to relapse. The scope of resection should follow the principles of superficial bladder cancer surgery. A total cystectomy was performed.
- 2. Intravesical medication
- Bladder perfusion medications are the same as those used for bladder tumors and fall into two categories:
- (1) Chemically toxic drugs can directly damage DNA and interfere with DNA replication. It mainly acts in the S phase and has no effect on the G0 phase, thereby inhibiting abnormal proliferation and atypical proliferation of abnormal bladder mucosa;
- (2) Immunosuppressive agents such as interleukin-2, BCG, and interferon can prevent the recurrence of the disease by stimulating systemic immune response and local response.
- Glandular cystitis after effective transurethral electrocautery or resection, the use of effective drug bladder infusion can further reduce the recurrence of glandular cystitis and improve the treatment effect of glandular cystitis.