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What is ectopia vesica (exstrophy)?
Defective anterior wall of the urinary bladder and anterior abdominal wall exposing the mucosal surface of the posterior vesical wall
May be associated with epispadias in males and split clitoris in females, complicated by urinary tract infection and carcinoma.
What is a patent urachus?
A fistulous tract that extends from the urinary bladder to the umbilicus, discharging urine to the outside
It is a congenital anomaly.
What is a bladder or vesical diverticulum?
A pouchlike evagination of the bladder wall, often acquired due to persistent urethral obstruction
Can lead to urinary stasis, recurrent urinary tract infections, and bladder stone formation.
What is cystitis?
Inflammation of the urinary bladder
Commonly caused by organisms such as E. coli.
Which organism is the most common cause of cystitis?
E. coli
Other organisms include streptococci, staphylococci, gonococci, and bacillus pyocyaneus.
Why are females more commonly affected by cystitis?
Due to a short urethra and pregnancy
This anatomical difference increases susceptibility to infections.
What are some predisposing factors for cystitis?
- Bilharziasis of the urinary bladder
- Stasis of urine
- Inflammation of nearby organs
- Trauma to the urinary bladder
- Congenital anomalies
- General diseases like diabetes
These factors compromise the epithelial lining’s resistance to infection.
What are the clinical features of acute cystitis?
- Frequent micturition
- Dysuria
- Pyuria
- Suprapubic pain
Grossly, the bladder wall is thickened, edematous, red, and congested.
What characterizes chronic non-specific cystitis?
It may follow repeated acute cystitis or start as such, with a thickened, congested bladder wall and increased fibrosis
Can lead to granularity of the mucosa.
What is interstitial cystitis?
A persistent painful form of chronic cystitis, most commonly in females
Involves inflammation extending into muscle layers, ending in transmural fibrosis.
What is malakoplakia?
A rare condition associated with immune deficiency states, characterized by yellow nodular thickenings in the trigone area
Microscopic examination reveals chronic inflammatory cells and Michaelis-Gutman bodies.
What is hemorrhagic cystitis?
Inflammation with intramural hemorrhage, often due to cytotoxic drugs or adenovirus infection
It presents with bleeding during urination.
What are the types of malignant tumors in the urinary bladder?
- Urothelial carcinoma
- Squamous cell carcinoma
- Adenocarcinoma
Urothelial carcinoma accounts for over 90% of bladder cancers.
What are the risk factors for malignant tumors of the urinary bladder?
- Urinary bladder bilharziasis
- Mechanical irritation from ova
- Repeated bacterial infections
- Aniline dyes
- Cigarette smoking
- Chronic irritation by stones and cystitis
Congenital anomalies like ectopia vesicae also contribute.
What are non-invasive papillary urothelial neoplasms?
Tumors that project into the lumen with a delicate papillary appearance
Graded into papilloma, low-grade, and high-grade papillary urothelial carcinoma.
What defines carcinoma in situ (CIS) in the urinary bladder?
High grade malignant cells taking the full thickness of urothelium without invasion of underlying lamina propria
Usually multifocal and can progress to muscle-invasive cancer if untreated.
What is the most important prognostic factor for urothelial carcinoma?
The extent of invasion or spread (stage) at the time of initial diagnosis
Early detection is crucial for better outcomes.
What is hematuria?
The presence of blood in urine
Blood from the kidney is mixed, while bladder blood appears at the end of micturition.
What are some causes of hematuria?
- Urinary bilharziasis
- Inflammatory diseases
- Renal stones
- Tumors of the urinary system
- Circulatory disturbances
- Congenital polycystic kidney
- Hemorrhagic blood diseases
Conditions like glomerulonephritis and leukaemias are included.
