This article will talk about how to treat bladder leukoplakia . Symptoms and causes of the pathology will also be considered. Considering the spectrum of possible diseases of the urinary system that can lead to a disorder of the act of urination, one cannot but mention a condition such as leukoplakia of the bladder. Often, patients can undergo multiple, but completely ineffective antibiotic therapy, linking their malaise with often recurring chronic cystitis.
The doctor prescribes treatment, mainly starting from complaints of the patient, but at the same time, as a rule, an insufficient number of instrumental studies are carried out. A diagnosis such as bladder leukoplakia is understood to mean long-term processes of an inflammatory nature, in which a focal replacement of the transitional epithelial layer by squamous cells is carried out in the organ.
Pathology Features
In the presence of leukoplakia of the bladder during cellular degeneration, keratinization sites appear that are not able to protect the bladder from the irritating effects of the chemical components included in the urinary composition. This disease is much more often recorded among the female population than in men. There is a direct connection of this fact with the features of the anatomical structure of the urethra, which in women is very wide for easy penetration of various kinds of infectious agents. It must not be forgotten that this process is a precancerous condition and, in the case of its long existence, is capable of giving rise to malignant neoplasms.
Causes of pathology
Bladder leukoplakia is classified as a multifactorial disease. To start this disease, the presence of several causes that can trigger the pathogenetic mechanism is necessary. The following causes are related to endogenous internal factors:
- The presence of hormonal disorders that are associated with an increase or, conversely, with a decrease in the amount of estrogen in the blood.
- The presence of abnormalities in the development of the organs of the urinary system, which, as a rule, are laid at the embryonic stage.
External factors include the following factors:
- The process of introducing bacterial agents into the tissue of the bladder and other structures of the urinary system with the subsequent development of inflammatory processes.
- The role of viral infections has been proven. In particular, this relates to the papilloma virus, which is able to change transitional epithelial cells, starting the process of their degeneration.
- Very often, the causes of the development of this disease are associated with the presence of foreign objects in the bladder. Damage to the walls of this organ, which occurs due to moving calculi, can also affect.
- Such processes may be due to exposure to substances with carcinogenic activity. The occurrence of complications due to radiation therapy is not excluded.
- The presence of promiscuous sexual intercourse. This, in turn, leads to the exchange of the most diverse strains of microorganisms between partners, including pathogenic chlamydia, trichomonads, and so on.
- Often, this painful process originates in weakened people taking a course of immunosuppressive treatment.
- The role of stress and psychoneurotic disorder, as well as conflict situations, is scientifically proven. Among other things, long sleep deprivation, along with a person’s lack of proper rest, can also affect.
What is this disease at the cellular level?
If we consider the morphological picture of this pathological process, then in its development leukoplakia of the bladder can go through several of the following stages:
- At the first stage, a single-layer epithelium is replaced by multilayer cells. Against this background, the structure of these cells remains absolutely normal.
- The process of degeneration of the squamous cell structure starts along with the premature death of healthy cells.
- The altered tissue is keratinized and plaques form.
Against the background of leukoplakia of the bladder in women, sites of flat keratinization may occur along with warty growths or foci that differ in erosion. Each form of the disease has different symptoms and determines the severity of the patient's well-being. Thus, in addition to the inflammatory component, this disease includes a sclerotic change in the walls of the organ, which leads to a violation of its contractile and reservoir functions.
What are the symptoms of bladder leukoplakia?
Symptoms of pathology
In general, the symptoms of this disease are very similar to a cystitis clinic. This is due to the fact that against the background of leukoplakia, processes of inflammation of the tissues of the bladder also occur along with disruption of the organ. It should be noted that the squamous type of this disease can go completely asymptomatic for a long time, while warty or erosive significantly worsen the patient's well-being, leading to severe dysuric disorder.
The most common symptom of leukoplakia of the bladder is pain associated with the act of urination. In addition to this, patients have other typical symptoms, among which are the following:
- Going to the toilet can only bring temporary relief, since after a few minutes a person again has an unbearable desire to urinate as soon as possible.
- The development of leukoplakia of the bladder may be accompanied by severe pain during emptying, and very often there is a burning sensation with a feeling of pain.
- There are complaints of a persistent feeling of fullness of the bubble. This knocks people out of the usual rhythm of life, making them always be as close to the toilet as possible.
- During urination, only a few drops may be released. This is due to the fact that a large amount of urine does not accumulate in the irritated organ.
- Constantly present pulling or aching pains in the lower abdomen, which can subside if the patient occupies a fairly comfortable position.
- Having sex brings a feeling of discomfort along with the pain that is given to the perineum and anal area.
- Patients often independently notice changes in the urinary sediment, which acquires a cloudy color. The occurrence of traces of blood or flaky inclusions is not ruled out.
Symptoms and treatment of bladder leukoplakia are interrelated.
Possible complications
If this disease is not cured in time, then the prerequisites for malignant degeneration will arise. Such a development is not excluded, since today there is no irrefutable evidence of the involvement or non-involvement of these pathological processes in oncological tissue transformations. Moreover, keratinization foci can completely turn off this area of the organ from work, in connection with this there is a threat of disturbances in the reservoir functions of the bladder.
Diagnostics
The basis for the diagnosis of leukoplakia of the bladder neck is correctly collected anamnestic information with the results that are obtained against the background of objective, laboratory and instrumental studies.
The symptomatology of leukoplakia, as already noted, is very similar to the manifestations of cystitis, in this regard, when questioning the patient, the doctor must determine whether antibiotic treatment was previously carried out and whether it was effective. In the event that adequate antibiotic therapy does not give a result, you can think about the presence of leukoplakia in the patient. Women must undergo a mandatory gynecological examination. During the examination, doctors take the necessary smears. A direct laboratory examination includes the following diagnostic techniques:
- Blood and urine tests.
- Perform urine culture on a nutrient substrate with the identification of the pathogen, its sensitivity to various antibiotics.
- In the framework of serodiagnosis, the DNA of the pathogen is determined.
- Ultrasound examination of the urinary system.
- Computer and magnetic resonance imaging, if necessary.
- Conducting cystoscopy, which is the basis of diagnosis. This procedure allows you to visualize foci of altered epithelium. Thanks to it, the localization and scale of the pathological process is determined, and a biopsy is taken for further histological studies.
What is the treatment for bladder leukoplakia?
Treatment principles
Leukoplakia in the projection of the Lieto triangle is considered the norm, therefore, in this case, treatment is not required. Such a triangle is usually limited by some structures, for example, the lower corner is represented by the opening of the urethra. The lateral corners are the outlet openings of the ureters.
When a specialist observes cellular transformation in this area, it does not pose any danger to the patient’s health, since its development is due to exposure to estrogen. Such patients need only dynamic monitoring, which should be carried out annually. Direct treatment of bladder leukoplakia includes the general principles of therapy along with conservative and surgical measures.
General recommendations
All patients who have been diagnosed with this disease are advised to follow a diet. The essence of such a diet is to exclude foods that can irritate the epithelium of the urinary organ. Food should be served in such paired or boiled form for such patients. The multiplicity of reception also plays a role. For example, food should be taken often, but in small portions, which will contribute to its better absorption. Among other things, you need to increase the consumption of fruits along with green vegetables, dairy products, meat and fish of low-fat varieties.
It is strictly forbidden to use dishes that contain spices with spices and a large amount of salt. Alcohol and coffee should be excluded. A special role is given to adequate fluid intake, which will help accelerate the elimination of various infectious agents from the bladder. The fact is that if a person limits himself in water, then favorable conditions are formed for the reproduction of pathogenic microbes. Be sure to have lingonberry fruit drinks with compotes, various teas based on herbs, mineral water and the like.
Conservative treatment
The approach to patient therapy should always be individual and combined. Much depends on the duration of the disease and its neglect.
In order to eliminate pathogenic microorganisms, patients with this disease are prescribed agents with antimicrobial and antibacterial activity. Antiviral medicines are used, among other things. Therapy is carried out in long courses, sometimes up to three months. The immediate question of discontinuing such treatment is established on the basis of the results of several bacteriological studies. In the event that, at the conclusion of sowing, the pathogenic microflora cannot be determined, the treatment carried out will be considered adequate and successful.
In the fight against the inflammatory components of the disease, anti-inflammatory drugs are used, which are used in tablets or in injection forms. To improve the trophic and regenerative process, patients are prescribed therapeutic instillation, that is, the necessary drugs are introduced through the urethra into the lumen of the bladder. This helps to speed up the healing of the body and eliminates the inflammatory process.
The use of various folk remedies in the treatment of leukoplakia of this organ has an auxiliary value. Properly selected herbs with their components have a beneficial effect on the work of the body, normalizing the act of urination and accelerating recovery. For these purposes, infusions of St. John's wort, calendula, ginseng, oat grains and other components are prepared.
Physiotherapeutic treatment methods are aimed at correcting, and in addition, at restoring the trophic process, as well as at preventing cicatricial growths and adhesions. In relation to the patient, magnetotherapy sessions are conducted along with electrophoresis with hormonal components, microwaves, etc. Also, cauterization of bladder leukoplakia with a laser is performed.
Surgery
Indications for the removal of leukoplakia of the bladder are:
- The presence of disorders of the contractile activity of the bladder, which is due to a long-existing inflammatory process.
- According to the results of histological studies, there are morphological symptoms of leukoplakia of the third stage, or cell atypia is detected that threatens cancerous degeneration.
- The patient is tormented by severe pain, which is difficult to treat with painkillers.
They resort to surgical intervention in cases where conservative therapy has been ineffective. The following methods of surgery are used for leukoplakia of the bladder:
- Transurethral organ resection. With the help of a loop, injured sections of the mucosa are removed. A cystoscope is inserted into the bladder through the urethra, which helps maintain the integrity of its walls.
- Laser coagulation. During this operation, it is possible to get rid only of the mucous layer without damaging the muscle membrane. Healthy tissues are practically not affected, which is an undoubted advantage of the method. The recovery period is quite short and takes no more than a month.
- Laser ablation During manipulation, the doctor precisely affects the affected cells, without affecting healthy areas. During the procedure, the probability of infection and bleeding is almost zero.
- Vaporization.
Reviews of leukoplakia of the bladder suggest that this disease is a very serious pathology that cannot be ignored and must be differentiated from cystitis. If you have the slightest symptoms of leukoplakia, you should consult a doctor.