1, congenital absence and hypoplasia of the bladder
Congenital absence of the bladder often accompanies congenital absence of the kidney, so there are very few survivors, a group19, 046Cases of autopsies have7Cases. There are25Cases. Congenital hypoplasia of the bladder refers to the retention of the cloaca, caused by the septal obstruction of the urachus. The ureters terminate in the rectum.
2, duplicated bladder
Is the result of embryonic developmental disorders, caused by a part of the embryonic tail against the birth, often accompanied by postrectal duplication. It can be divided into left and right, anterior and posterior, or upper and lower two bladders, gourd-shaped or polycystic bladder. A group18Cases5About 0% with lower gastrointestinal duplication malformation, a group2In 0 cases of postrectal duplication malformation6About 0% have duplicated bladders. The incidence of associated with repeated external genitalia is also high. Urinary tract obstruction and infection symptoms may occur, and a treatment plan must be formulated after a comprehensive examination based on the condition of bladder lesions and other specific congenital abnormalities of organs, including relieving urinary tract obstruction, retaining bladder function,整形 and correction of external genitalia, and correction of digestive tract malformations, etc.
3, bladder diverticula
Due to the presence of localized congenital weakness in the bladder wall, and the presence of obstructive factors in the lower urinary tract during fetal development, the intravesical pressure increases, leading to the突出 of the detrusor muscle bundles between the bladder wall and the formation of diverticula. But there are also cases where there is no anatomical obstruction in the bladder neck and urethra. Therefore, its formation is related to the abnormal arrangement of bladder muscle fibers. It is more common in men and is often solitary, most of which are located near the ureteral orifice. After the diverticulum is formed, it fills up each time it urinates and gradually increases in size. Over time, the ureter is brought into the diverticulum, causing the submucosal segment and the interstitial segment of the oblique ureter to disappear, resulting in vesicoureteral reflux. Bladder diverticula are often discovered after further urological examination due to urinary tract infection or difficulty in urination. The diagnosis mainly relies on urography, which can show the shape and location of the bladder diverticula. If necessary, supplemented by cystoscopy. The treatment is mainly to relieve lower urinary tract obstruction, control infection, and perform diverticulectomy, or add urinary bladder ureteral reanastomosis to prevent reflux.
4, cystocele
The cystocele and urethral cleft complex malformation is at the embryonic stage4～10At the same time, developmental abnormalities caused by the excessive development of the cloacal membrane prevent the migration of mesenchymal tissue and the normal development of the lower abdominal wall. The time and location of the rupture of the cloacal membrane are different, resulting in a series of malformations from the glans urethral cleft to the cloacal inversion. The typical bladder exstrophy is only a part of this kind of malformation, accounting for about5About 0%, with an incidence rate accounting for about 0% of newborns.1/1～5Ten thousand, and men are twice as many as women, and the risk of inversion in their offspring is higher than that in the normal population.500 times, but the genetic type has not been determined yet.
