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膀胱攣縮是泌尿系結核的重要併发症,其发病率較高(14.3％),后果严重,往往影响治疗效果。腸、膀胱成形术是治疗膀胱攣縮的較好方法,我科自1957年以来治疗11例,最长者已观察6年,疗效滿意。病理学在泌尿系結核的癒合过程中,若膀胱病变严重,由于纤维組織增生,瘢痕收縮,往往可形成膀胱攣縮;容量縮小,产生严重影响: 一、尿次增多,增加患者痛苦,病理严重者可产生尿失禁,影响工作或休息。二、腎盂积水,腎机能减損。其发生机制有二: (一)由于膀胱容量縮小,排尿頻繁,膀胱經常处于收縮状态,膀胱內压也随之增高,以致形成输尿管梗阻、扩张,腎盂积水。严重威胁腎脏机能。 (二)膀胱攣縮累及健側輸尿管口,形成瘢痕狭窄或閉鎖不全,由于梗阻或反流的作用,以致輸尿管逐漸扩张,腎盂积水,最后影响腎脏功能。
Bladder contracture is an important complication of urinary tuberculosis, its incidence is high (14.3%), the consequences are serious, often affect the treatment effect. Intestinal, bladder surgery is a better method of treatment of bladder contracture, our department since 1957 treatment of 11 cases, the longest observed 6 years, with satisfactory results. Pathology in the healing process of urinary tuberculosis, if the bladder lesions, due to fibrous tissue proliferation, scar contraction, often can form bladder contracture; capacity reduction, have a serious impact: First, increased urination, increased patient pain, pathological severe Can produce incontinence, affecting work or rest. Second, hydronephrosis, renal impairment. Its mechanism has two: (a) due to bladder capacity reduction, frequent urination, the bladder is often in a contracted state, bladder pressure also increased, resulting in the formation of ureteral obstruction, expansion, hydronephrosis. Serious threat to kidney function. (B) Bladder contracture involving the contralateral ureteral orifice, the formation of scar stenosis or atresia, due to obstruction or reflux, resulting in the gradual expansion of the ureter, hydronephrosis, the final impact on renal function.