Duplicated bladder

　　Duplicated bladder mainly occurs during the embryonic period when the bladder urethra primordium is directionally split. If accompanied by abnormal development of the rectum, it indicates that the splitting occurs before the cloaca septum is formed into anterior and posterior parts. Conversely, if there is no abnormal development of the rectum, it indicates that the splitting occurs after the cloaca is separated. The bladder begins to develop during the 5th to 7th week of embryogenesis. If a sagittal or additional uraco-rectal septum further separates the bladder primordium, it may cause duplicated bladder and posterior intestinal duplication. Some people believe that the duplicated posterior intestinal duplication of the embryonic tail is the effect of duplicated bladder. Some people believe that it is caused by unbalanced growth of the ectoderm and endoderm or excessive mucosal folds and fusion during the development of the bladder primordium.

　　In addition to posterior intestinal duplication and coccygeal duplication, duplicated bladder can also be accompanied by other serious urinary tract malformations, such as ectopia vesica, ectopic ureteral orifice. In addition, this disease may cause abnormality of external genitalia, with 90% of males accompanied by duplicated penis or duplicated urethra, and females with duplicated fallopian tubes, duplicated uterus, and duplicated vagina.

　　Duplicated bladder often leads to stillbirth or death soon after birth due to combined upper urinary tract or other organ malformations, which can be manifested clinically as urinary tract irritation symptoms, urinary incontinence, and other symptoms of malformations. However, duplicated bladder can also be asymptomatic for a long time and discovered occasionally or diagnosed due to concurrent urinary tract infection, calculus, and urinalysis.

　　The etiology of duplicated bladder is due to the directional splitting of the bladder urethra primordium during embryonic development. If accompanied by abnormal development of the rectum, it indicates that the splitting occurs before the cloaca septum is formed into anterior and posterior parts. Conversely, if there is no abnormal development of the rectum, it indicates that the splitting occurs after the cloaca is separated. The bladder begins to develop during the 5th to 7th week of embryogenesis. If a sagittal or additional uraco-rectal septum further separates the bladder primordium, it may cause duplicated bladder and posterior intestinal duplication. Therefore, this disease cannot be prevented directly, and early detection, early diagnosis, and early treatment are of great significance for the indirect prevention of the disease.

　　When recurrent bladder is complicated with infection, pus cells and red blood cells may be found in the urine, and this disease also has the following auxiliary examinations.

　　1. Imaging Examination:Ultrasound and CT scans can detect two bladders or a longitudinal septum within a bladder, sometimes a multicavitary bladder or a gourd-shaped bladder is found, with each bladder having a good muscle layer and mucosa. Other organ malformations can also occur, and intravenous urography and excretory bladder urethrogram can make a definite diagnosis.

　　2. Ureteroscopy:Complete recurrent bladder can be found with double urethras and double bladders, and only one bladder can be entered at a time.Incomplete recurrent bladder can be found with sagittal or frontal septa within the bladder, or even multicavitary bladder.

　　In addition to routine treatment, patients with recurrent bladder should also pay attention to the following aspects in diet, mainly light and savory, eat more vegetables and fruits, rationally match the diet, and ensure adequate nutrition.

　　Bladder cancer is mostly characterized by deficiency in the interior and excess in the exterior. The interior deficiency includes kidney qi deficiency, spleen qi deficiency, lung qi deficiency, and liver qi stagnation, while the excess in the exterior is due to damp-heat, toxic heat, phlegm turbidity, and blood stasis. The therapeutic principle of Chinese medicine treatment should focus on tonifying the kidney, strengthening the spleen, and benefiting the lung, supplemented by diuretic hemostasis,清热止血, detoxifying blood stasis. At the same time, the application of Chinese medicine can reduce the toxic and side effects of chemotherapy and improve the patient's tolerance to chemotherapy. Moreover, the effect is significantly better than that of patients undergoing chemotherapy alone. However, due to certain objective reasons, the treatment of bladder tumors with traditional Chinese medicine is still mostly limited to middle and late-stage cases, and the mortality rate is still very high. Therefore, it is still necessary to carry out multi-directional prospective clinical research, further explore, organize, and screen effective cancer-fighting herbal formulas and formulate reasonable treatment plans, adopt comprehensive treatment methods, and strive to improve the clinical survival rate.