What Do I Do About Bladder Weakness?
Ureteral prolapse, also known as ureteral cyst or ureteral bulge, refers to the cystic bulge into the bladder at the end of the ureter, the bulged outer layer is the bladder mucosa, the middle layer is the superficial muscular layer of the triangular region and the collagen tissue. Mucosa of the ureter. Rarely clinically, the cause may be long ureteral development, muscular hypoplasia, weak ureteral and bladder wall muscular layers, strong contraction of the ureter, and prolapse of the ureteral mucosa into the bladder.
- nickname
- Ureteral cyst or ureteral bulge
- English name
- prolapse of ureter, ureterocele
- Visiting department
- Urology
- Multiple groups
- Children, women
- Common locations
- ureter
- Common symptoms
- Pain, poor urination, urinary tract infections, stones
Basic Information
Causes of ureteral prolapse
- Most of the ureteral bulges originate from the upper ureter, which repeats the renal ureter. There are more women than men, which can occur on one side of the ureter, or on both sides of the ureter. The cause of this disease is not clear, and there are several views:
- 1. Chwalle membrane delayed rupture caused dilatation of the ureter and narrowing of the orifice.
- 2. Delayed separation of the developing ureter from the mesenteric duct may cause dilatation of the end of the ureter.
- 3. Segmental embryo stagnation in the developing distal ureter, which stagnates muscle development in the distal ureter, causing ureteric cysts.
Clinical manifestations of ureteral prolapse
- Pain
- Due to the obstruction caused by the ureteral cyst, hydronephrosis is gradually formed, and there may be pain in the waist of the affected side.
- 2. Urinary disorders
- A ureteral cyst can block the inner urethral opening, and can even prolapse from the outer urethral opening. The cystic tissue that comes out is a red mucosal cyst that can cause poor urination, interruption of urine flow, and urinary retention.
- 3. Urinary tract infection
- Easily secondary to urinary tract infections, with frequent urination, urgency, and dysuria, and recurrent episodes.
- 4. Stones
- Stones can be combined in the cyst, and renal colic and hematuria appear.
Ureteral prolapse examination
- Urine routine
- Patients with urinary tract infection or stones, routine urine examination showed red blood cells and white blood cells.
- 2. Determination of urine osmotic pressure
- Impairment of renal concentrating function can occur early in the course of the disease.
- 3. Determination of renal function
- Serum creatinine and urea nitrogen increased progressively with the loss of renal compensatory function, and creatinine clearance was also a more sensitive indicator.
- 4. Intravenous urography
- Most ectopic ureteric cysts occur in the kidneys. The deformed kidneys do not develop due to poor kidney function. The lower half of the kidney that is developed shifts outwards and downwards and looks like a lily flower. There is a sea snake head-like filling defect in the bladder area. ; You can also learn about bilateral renal function.
- 5. Bladder urography
- Urinary bladder urography shows that most of the ureteral cysts complicated by double ureters have lower ureteral reflux; occasionally male patients with prolapsed ureteric cysts are easily confused with posterior urethral valves.
- 6. Bladder urethroscopy
- The size of the cyst and the opening of the cyst were determined.
Diagnosis of ureteral prolapse
- This disease is more common in children, and more frequent urinary tract infections are more common in women. Patients with dysuria should consider the possibility of this disease, especially female children with red suspicious objects at the urethral opening, which should be highly suspected; , Combined with imaging and endoscopy can confirm the diagnosis.
Ureter prolapse treatment
- Except for a few cases where the affected kidney has been irreversibly damaged, no decision should be made to remove the affected kidney.
- Ureteral cyst in situ
- Cystoscope incision cysts are suitable for adults, but need to pay attention to bleeding, and sometimes need electrocautery to stop bleeding. Patients should use the surgical approach of the bladder incision.
- 2. Ectopic ureteral cyst
- Simple cystectomy is wrong for ectopic ureter. The choice of surgical method should be based on the specific condition. It is mainly based on the severity of the affected kidney, the degree of ureteral dilatation, the function of the contralateral kidney, and whether there are infections and stones at the same time. The bladder is cut through the pubic bone, and the cyst is completely removed, including the extension to the urethra, to prevent urethral obstruction after the operation. After the removal, the symptoms generally improve, but the infection rarely disappears in time. But it is rare to fully return to normal. If the postoperative infection is severe and cannot be controlled, the affected kidney and ureterectomy can be performed in two stages. If the kidney is repeated, partial nephrectomy (including all ureters to which it belongs) can be performed. If accompanied by weak bladder posterior wall must be repaired.
- 3. Ureteral bladder replantation
- If bladder ureteral reflux occurs after ureteral cyst resection, ureteral bladder anti-reflux replantation should be considered.