Tuberculous bladder contraction

　　The causes and pathological changes of bladder contraction are that the tubercle bacilli often repeatedly invade the bladder from renal tuberculosis, causing severe tuberculous cystitis. In the mucosal and muscular layer of the bladder, congestion, edema, tuberculous nodules, tuberculous ulcers, and tuberculous granulation tissue are produced, with a large number of lymphocytes infiltrating and fibrous tissue formation. Finally, bladder contraction occurs. After bladder contraction, the bladder wall loses its normal elasticity, and the capacity is significantly reduced. It is generally believed that the capacity of the contracted bladder is below 50ml. In severe cases, the bladder can shrink to several milliliters of capacity. Due to the repeated infection of the bladder by the tubercle bacilli, the pathological changes in the bladder are an acute and chronic, inflammation and fibrosis, a process of repeated interaction.

　　1. Urinary system infection:Due to the shrinkage of the bladder volume after contraction and frequent urination, it is easy to cause pathogenic organisms to ascend through the urethra and infect the ureters and bladder, leading to urinary system infection.

　　2. Hematuria:The kidneys, ureters, and bladder undergo mucosal damage under the repeated stimulation of Mycobacterium tuberculosis, leading to hematuria due to the rupture of capillaries.

　　3. Renal failure:Patients with bladder contraction usually have ureteral contraction, so renal function failure can occur due to the obstruction of renal excretion function.

　　1, Significant urinary frequency, with a very small amount of urine each time, severe cases may have urinary incontinence; often accompanied by urinary pain, pyuria, hematuria, and other symptoms.

　　2, When there is hydronephrosis on the contralateral kidney, a mass can be felt in the upper abdomen.

　　3, Severe cases may have symptoms of chronic renal insufficiency.

　　Widely popularize knowledge of infectious diseases, do a good job in the prevention of infectious diseases, and actively treat systemic tuberculosis. The treatment of tuberculosis must be standardized to avoid recurrence and induce the disease. During the treatment process, the principles of early, full course, combined, moderate, and standardized treatment should be followed to avoid missed doses causing drug resistance. The treatment course usually lasts 6-9 months, so confidence and patience are required. With regular treatment, the prognosis is generally good.

　　Strengthen nutrition, unless azotemia, high-protein diet can be eaten. The patient's diet should be light and easy to digest, eat more vegetables and fruits, reasonably match the diet, and pay attention to sufficient nutrition. In addition, patients need to pay attention to avoid spicy, greasy, and cold foods.

　　The treatment of bladder contracture due to tuberculosis often requires surgery. If there is no urethral stricture and the condition permits, a sigmoid colon bladder augmentation should be performed. After long-term follow-up, the effect is good. If there is urethral stricture, a urinary diversion surgery should be chosen. If due to severe illness, the patient cannot tolerate major surgery, a permanent nephrostomy or ureterostomy should be performed. In any case, it is necessary to combine oral anti-tuberculosis drug treatment at the same time, which is an indispensable and very important treatment method.