Cystostomy tube replacement

If you have some serious bladder diseases, and even if they cannot be improved by ordinary conservative methods, you can only use a cystostomy catheter as a treatment surgery to relieve the symptoms. However, you still need to replace it regularly after implantation. In addition, you still need to take good care of your body in life, avoid keeping your body in a relatively tiring state for a long time, and protect it well.

If there are no complications, bladder diverticulum has no special symptoms. If there is obstruction or infection, symptoms of urinary tract infection such as difficulty urinating, frequent urination, and urgency may occur. Some diverticula can be as large as 2000ml, compressing the bladder neck and urethra, leading to lower urinary tract obstruction. The lack of muscle contraction in the diverticulum leads to poor urine drainage, which is easily accompanied by ureterovesical reflux, unilateral or bilateral hydronephrosis, and ultimately leads to renal failure.

However, there are also cases of congenital giant diverticula that do not cause urinary tract obstruction. Because the muscle fibers in the wall of the bladder diverticulum are very few, urine in the giant diverticulum cannot be discharged during urination, resulting in symptoms of secondary urination. Some patients have hematuria due to infected stones in the diverticulum. A small number of patients may have urinary retention due to compression of the bladder outlet by the huge diverticulum located behind the bladder neck, constipation caused by compression of the rectum, and dystocia caused by compression of the uterus.

[Imaging manifestations]

1. Urinary tract angiography: It appears as a saccular shadow protruding from the bladder, with a neck connected to the bladder.

2. Ultrasound manifestations: showing a sac-like or spherical liquid dark area connected to the side or posterior wall of the bladder, and enhanced echo of the posterior wall.

3. CT manifestations: Enhanced scans show cystic or spherical shadows filled with contrast agent protruding outside the bladder. If there are stones or tumors in the diverticulum, filling defects may be seen.

[Differential diagnosis]

Giant bladder diverticula need to be differentiated from duplicated bladder.

Bladder neck contracture is another important bladder neck obstruction problem. The so-called bladder neck refers to a tubular structure about 1 to 2 centimeters long extending from the internal urethral opening into the urethra. It includes the internal sphincter, but the internal sphincter is not the entire bladder neck. Bladder neck contracture can be divided into congenital and acquired types in terms of etiology.

Congenital cases often have no other clear causes except for typical local pathological changes, and are more common in males; acquired cases are often caused by local chronic inflammation such as posterior urethritis, prostatitis, trigonitis, etc., and the incidence rate in females is no lower than that in males. Congenital cases are more common in children, who often have symptoms of urination disorders before the age of six, but it is not uncommon for the disease to occur after the age of 20 or 30.