Leukoplakia of the bladder is accompanied by inflammation of the walls of the organ, but there are no obvious clinical signs of the disease. Therefore, women suffering from this pathology can visit various specialists for a long time, and the diagnosis remains unclear.

Bladder leukoplakia - what is it

- This is the degeneration of normal epithelium into a flat epithelium with the formation of areas of keratinization. It will be possible to detect these pathological changes only after a biopsy with a histological examination of the collected tissues.

Leukoplakia can affect various organs in which transitional epithelium is present. Leukoplakia of the bladder and its neck is a serious condition that most often affects women of reproductive age. Pathology is accompanied by intense pain, which negatively affects the patient's well-being. Painful sensations arise due to the fact that the altered tissues are sensitive to the effects of the acid contained in the urine.

Bladder leukoplakia has a chronic course.

The disease develops in stages:

Squamous degeneration. At this stage, the transformation of the single-layer transitional epithelium into the squamous stratified epithelium occurs. The cells themselves do not undergo any changes.

Squamous metaplasia. At this stage, apoptosis is observed, that is, a change in cells in the transformed stratified squamous epithelium.

Plaque formation and keratinization of cells.

Leukoplakia of the bladder is accompanied by sclerotic processes of the walls of the organ. Over time, it loses its normal contractile function, which becomes the cause of urinary incontinence. This does not happen with normal inflammation.

Scientists cannot accurately name the reasons for the development of this pathology. Most experts are of the opinion that leukoplakia is the result of abnormal intrauterine development. This means that the walls of the bladder are formed with certain defects even while the fetus is in the uterus. The proof of this theory is the fact that the pathology is diagnosed in patients with anomalies in the development of the bladder.

In addition, there are risk factors that can increase the likelihood of getting sick.

These include:

Diseases of the endocrine system. This applies to disorders in the hypothalamus, pituitary gland and ovaries. If the values ​​of estrogens are increased in the woman's body, then this stimulates the epithelium to metaplasia. Sometimes the disease develops while taking hormonal drugs.

Inflammation of the bladder and bodies located next to it. Leukoplakia can be provoked by a chronic form of cystitis, stones in the bladder, organ injuries suffered, as well as the ingress of foreign objects into it.

The presence of a chronic focus of infection in the body, for example, carious teeth or inflamed tonsils.

Long-term effects of stress on the body, decreased immunity.

The degeneration of epithelial cells of the bladder often occurs under the influence of infection.

If the organ is healthy, then its epithelium will produce mucopolysaccharides. They prevent bacteria from sticking to the surface of the bladder. These same substances protect cells from the damaging effects of uric acid.

When the epithelium of the organ is transformed into a flat one, its protective properties are weakened. This facilitates the penetration of pathogenic flora into the cell walls. The woman develops chronic inflammation. A kind of vicious circle is being formed. Cystitis causes leukoplakia, which, in turn, stimulates the inflammatory process.

Bacteria enter the bladder most often ascending, that is, from the external genitalia.

Therefore, leukoplakia can be provoked by such pathogenic microorganisms as:

Gonococci.

Trichomonas.

Through the blood and lymph, the infection into the bladder is less common. In this case, other organs can become the source of pathogenic flora: palatine tonsils, kidneys, intestines, uterus, ovaries. In such a situation, leukoplakia develops due to the penetration of staphylococci, streptococci, Escherichia coli, etc. into the bladder.

Metaplasia of the epithelium in the Lieteau triangle (the zone of transition of the bladder to the neck) is considered a normal variant. This tissue change occurs under the influence of estrogen. If the epithelium with such metaplasia does not become keratinized and does not lead to the appearance of pathological symptoms, then treatment is not required. The patient is simply being watched.

There are three forms of bladder leukoplakia:

Flat shape.

Warty form. Areas of keratinization of tissues are expressed to a significant extent.

Erosive form. The epithelium is covered with ulcerative defects.

Flat leukoplakia may not manifest itself in any way for a long time. With a warty and ulcerative form, a woman suffers from severe symptoms of the disease. If the bladder neck is damaged, then the patient's well-being significantly worsens.

The main symptoms of bladder leukoplakia resemble the clinical picture of cystitis:

Pain in the pubic area. It pulls and radiates to the lower back.

The urge to empty the bladder becomes more frequent.

When the organ is emptied, the woman experiences pain and burning sensation.

Flakes are visible in the urine, blood can be visualized.

During intimacy, a woman experiences discomfort.

Impurities in the urine and pain when urinating do not always indicate leukoplakia. A woman can suffer from pain for a long time, and taking tests does not reveal signs of infection and inflammation. Sometimes these patients are diagnosed with an overactive bladder and are prescribed sedatives.

The doctor can make a diagnosis only after a comprehensive examination. The obligatory procedure is the histology of the tissues of the organ.

To confirm the disease, diagnostic measures such as:

Collecting anamnesis. The doctor should clarify how often a woman has seizures, whether she has other diseases of internal organs. It is important to find out all the possible predisposing factors of the disease.

Vaginal examination. It allows you to assess the sexual health of a woman.

Donation of blood, urine and vaginal smear for analysis.

Conducting a biochemical blood test. It is important to check the level of creatinine and urea.

Research by PCR and ELISA. These diagnostic procedures help identify hidden infections.

Collection of urine and vaginal smear for bacterial culture.

Ultrasound of the pelvic organs and kidneys.

Urodynamic examination (cystometry and urometry). It is performed when the patient indicates a feeling of incomplete emptying of the bladder. The study allows you to assess the tone of the organ and its contractile ability.

Endoscopic examination of the bladder with a pinched biopsy. This study is highly informative. It makes it possible to assess the size of the lesion, the form of the disease, the condition of the tissues of the organ. Based on the data obtained, a treatment plan is drawn up. Lesions may appear as flat, whitish patches, yellow plaques, or erosion.

An accurate diagnosis can be made only after the obtained biopsy data are obtained. They must confirm the presence of metaplastic changes in the cells of the organ.

The clinical picture of bladder leukoplakia may resemble the symptoms of other diseases, therefore it is important to carry out differential diagnosis with such pathologies as:

Chronic cystitis. The symptoms of this disease are similar to those of leukoplakia. They can only be distinguished after a cystoscopy with a biopsy. In patients with cystitis, the mucous membrane of the organ is inflamed, but there are no low-lying areas on it.

Bladder cancer. Often this disease does not give any symptoms at all, but as the pathology progresses, clinical signs appear that resemble leukoplakia. During the cystoscopy, ulcerative defects and altered areas of the epithelium will be found on the mucous membrane. However, cells in bladder cancer will be atypical.

It is possible to talk about an accurate diagnosis only after an endoscopic examination of the bladder with a biopsy of the material.

Bladder leukoplakia treatment

Treatment can be both conservative and surgical.

To cope with pathology, an integrated approach is required:

Prescribing antibacterial drugs. Antibiotics are used in long courses that can last up to 3 months. In the course of treatment, the drugs are changed, choosing the optimal drug. The course is stopped only after the bacterial culture of urine three times gives negative results. The drugs of choice are Norfloxacin, Ciprofloxacin, and Levofloxacin. They have minimal side effects and are able to effectively eliminate the pathogenic flora in the bladder.

Preparations for the relief of inflammation. If it is intense, corticosteroids such as Prednisolone may be used.

Preparations for increasing immunity: Interferon, Lavomax.

Installations. Irrigation of the urinary bladder is performed with mucopolysaccharide analogs. They allow you to protect the mucous membrane of the organ from the destructive effects of uric acid and microbial flora. Such funds are injected directly into the organ using a catheter. Treatment should be prolonged. Its specific timing depends on how much the bladder wall is affected. For installations using Heparin, Hyaluronic acid and Chondroitin sulfate.

Physiotherapy treatment. It allows you to speed up recovery, reduce the degree of inflammation, and prevent the formation of scars and adhesions. The most effective methods of treatment: laser therapy, electrophoresis with hormonal drugs, magnetotherapy, microwave therapy.

Surgery

If conservative therapy fails to achieve the desired effect, the patient is prepared for surgery.

The indications for its implementation are:

Persistent inflammation, accompanied by a violation of the contractility of the bladder.

Stage 2 or 3 leukoplakia, which was confirmed by histological examination.

Severe pain, which cannot be eliminated by drugs.

The presence of atypical cells. This condition threatens with a cancerous tumor of the organ.

Types of surgical intervention:

TUR (transurethral resection of the bladder). During the procedure, the affected areas of the mucous membrane are removed. For this, use a special loop. The device is inserted through the urethra using endoscopic equipment for this purpose. This procedure allows you to preserve the integrity of the bladder.

Laser coagulation of the bladder. During the operation, only the mucous structures damaged by the disease are removed. The muscular layer of the organ is not touched, that is, healthy tissues do not suffer with this type of intervention. The patient is recovering quickly, the rehabilitation period is one month.

Laser ablation. In this case, the tissues of the organ are not cauterized, the thermal effect is not aggressive. The impact is punctual, healthy tissues are not affected. The likelihood of developing complications is minimal. Rehabilitation after such a procedure is quick.

On the second day after the operation, the woman is allowed to go home. The process of urination returns to normal within 7 days. During this time, the woman may experience pain and discomfort.

To improve the effectiveness of treatment, the patient must follow a diet. Food and drinks must be selected in such a way that they do not irritate the mucous membranes of the organ. Food is steamed or boiled.

Fresh sweet fruits.

Fresh and cooked vegetables. White cabbage, cauliflower, tomatoes, garlic, onion, sorrel and radish are removed from the menu.

Low fat fish and meat.

Milk and fermented milk drinks.

You need to drink about 2 liters of water per day. This will allow faster removal of bacteria from the bladder and reduce the effect of uric acid on the walls of the organ. You can drink herbal teas, black and green tea without sugar, fruit drinks with lingonberries and cranberries, pure water, still mineral water.

It is forbidden to eat:

Seasonings.

Spicy dishes.

Marinades and salinity.

Rich soups.

Smoked products.

Fried foods.

Strong tea, coffee, spirits.

Complications

After undergoing treatment, a woman will need to be tested regularly. From time to time she undergoes a cystoscopy of the organ. This will eliminate the recurrence of pathology.

Possible complications include:

Malignancy with the development of a cancerous tumor.

Loss of normal bladder function. The tissues of the organ stop contracting and cannot hold urine.

Considering the entire spectrum of possible diseases of the urinary tract, which to one degree or another can lead to disorders of the act of urination, one should not lose sight of such a condition as bladder leukoplakia.

Often, patients undergo multiple, but absolutely ineffective treatment with antibacterial drugs, linking their condition with the often recurrent form of chronic cystitis. The doctor prescribes treatment based on the patient's complaints, while, as a rule, he is given an insufficient range of instrumental studies.

Leukoplakia of the bladder is a long-term inflammatory process in which focal replacement of the epithelial layer of the transitional type with squamous epithelium cells occurs in the organ.

In the process of cellular degeneration, areas of keratinization appear, which are not able to protect the bladder from the irritating effects of chemicals that make up the urine.

The disease is much more often recorded among the female population, like most diseases of the urinary tract. There is a direct connection of this fact with the peculiarities of the anatomical structure of the urethra (urethra), which in women is wide enough for the free penetration of various kinds of infectious agents.

It must be remembered that this process is a precancerous condition, and it, with its long existence, is capable of giving rise to a malignant neoplasm.

Causes of occurrence

Bladder leukoplakia is a multifactorial (polyetiologic) disease. For its onset, several reasons are required that could trigger pathogenetic mechanisms.

Endogenous (internal) damaging factors include:

• hormonal disorders associated with an increase or decrease in the level of estrogen in the blood (with pathology during ovulation, during postmenopause and other conditions);
• abnormalities in the development of the organs of the urinary tract, which are laid even at the embryonic stage.

Exogenous (external) reasons include:

• the introduction of bacterial agents into the tissues of the bladder and other structures of the urinary tract, with the development of an inflammatory process in them, especially with a chronic nature of the course (cystitis, urethritis, and others);
• the role of viral infection has been proven, especially among representatives of the human papillomavirus, which are able to change the transitional cells of the epithelium and start the process of their "degeneration";
• often the cause of the development of the disease is associated with the presence of foreign objects in the lumen of the bladder or with damage to its walls by moving calculi;
• the process may be due to the effects of substances with carcinogenic activity or is a complication of radiation therapy;
• promiscuous sexual relations lead to "exchange" between partners of various strains of microorganisms, including pathogenic (Trichomonas, chlamydia and others);
• often the disease process originates in debilitated patients taking a course of immunosuppressive therapy or HIV-infected;
• the role of stress, psychoneurotic disorders, conflict situations, prolonged lack of sleep and lack of adequate rest has been proven.

The experience of smoking plays a certain role, as in women who abuse tobacco products, the disease is much more common

What is the process at the cellular level?

If we consider the morphological picture of the process, then in its development leukoplakia goes through several stages:

• at the first stage, the transitional monolayer epithelium is replaced by multilayer flat cells, while the structure of these cells remains normal (squamous cell modulation);
• the process of degeneration of squamous cell structures and premature apoptosis (death) of healthy cells (squamous cell metaplasia) is started;
• altered tissues undergo keratinization, plaques are formed (metaplasia with keratinization).

With leukoplakia of the bladder, areas of flat keratinization, warty growths or foci with an eroded surface appear. Each of these forms of the disease has different symptoms and determines the severity of the patient's condition, and, therefore, the tactics of treatment.

Thus, in addition to the inflammatory component, the disease includes sclerotic changes in the walls of the bladder, which leads to a violation of its contractile and reservoir function.

Symptoms

In general, the symptoms of the disease are very similar to the clinic of cystitis, since during the process the tissues of the bladder become inflamed and the functioning of the organ is disrupted.

An urinary disorder is a symptom of a problem in the bladder

It is worth noting that the squamous form of the disease can be absolutely asymptomatic for a long time, while warty or erosive leukoplakia significantly worsens the patient's well-being and leads to severe dysuric disorders.

The most common signs of the disease are pain associated with the act of urination and disturbances in the functioning of the bladder (persistent dysuria).

The patient has the following typical symptoms:

• leukoplakia of the bladder neck is accompanied by severe pain when emptying the bladder, there is a burning sensation and a feeling of cramps;
• going to the toilet brings only temporary relief, since after a few minutes the patient again has an intolerable desire to urinate;
• patients complain of a persistent feeling of fullness in the bladder, which knocks it out of the usual rhythm of life and forces it to always be near the toilet;
• during urination, only a few drops may be released, since a large volume of urine cannot accumulate in the irritated organ ("false" urge);
• there are unpleasant pulling or aching pains in the lower abdomen, which subside a little after the patient takes a comfortable position in bed;
• having sex brings a pronounced feeling of discomfort or pain that radiates to the perineum, anal area;
• often patients independently note a change in the nature of the urinary sediment, which becomes cloudy, traces of blood or flocculent inclusions may appear.

"Toilet addiction" leads patients to social maladjustment and knocks them out of the usual rhythm of life

Complications

If the disease is not treated in time, then there are prerequisites for its malignant transformation (some researchers exclude this possibility, since there is no irrefutable evidence of the involvement or non-involvement of the process in the oncological transformation of the bladder tissue).

Focuses of keratinization are able to completely "turn off" this part of the organ from work, therefore there is a threat of disruption of the reservoir function of the organ.

Leukoplakia can indirectly affect the development of a condition such as renal failure, which poses a threat to the patient's health

Diagnostics

The basis of the diagnosis is correctly collected anamnestic data and the results that will be obtained during objective and laboratory-instrumental research.

The symptoms of bladder leukoplakia resemble the clinic of cystitis, therefore, when questioning the patient, the doctor should clarify whether antibiotic therapy has been previously carried out, and whether it was effective. As a rule, if adequate antibacterial treatment did not give the desired result, then it is worth considering whether the patient has leukoplakia.

Women are subject to compulsory gynecological examination on a chair. The necessary smears are taken.

Laboratory and instrumental examination includes:

• blood and urine analysis, if necessary, additional samples are prescribed (urine according to Nechiporenko and others);
• sowing urine on nutrient substrates with the identification of the pathogen and the determination of its sensitivity to certain antibiotics;
• serodiagnostics includes the determination of DNA pathogens and antibodies produced against it;
• Ultrasound of the urinary system;
• CT and MRI if necessary;
• cystoscopy is the basis of diagnostic measures, since it allows you to directly visualize foci of altered epithelium, determine the localization and extent of the process, and also take biopsy material for histological and cytological examination.

Cystoscopy is a procedure without which a diagnosis is impossible

Treatment principles

Leukoplakia in the projection of the anatomical Lieto triangle is considered a normal variant and does not require therapy. This triangle is limited by the following structures: its lower angle is represented by the opening of the urethra (urethra), and the lateral angles are the outflow openings of the ureters.

Therefore, when a specialist sees zones of cellular transformation in this area, they do not pose any danger to the patient's health. Their development is due to the influence of estrogens. For such patients, only dynamic annual observation is necessary.

Treatment of bladder leukoplakia includes a number of general principles of therapy and conservative-surgical measures.

All patients who have a disease are recommended to follow a diet, the essence of which is to exclude from the diet foods that can irritate the epithelium of the bladder.

Food should be served boiled or steamed. The frequency of its intake plays a role: food is taken often, but in small portions, which contributes to its better assimilation. It is worth increasing the consumption of fruits and green vegetables, dairy products, lean meats and fish.

In order to speed up the process of destroying microorganisms, it is necessary to eat healthy and "correct" food

It is strictly forbidden to eat foods containing spices, herbs, large amounts of salt. All alcoholic and caffeinated products are excluded.

A special role belongs to adequate fluid intake, which accelerates the elimination of infectious agents from the lumen of the bladder. On the contrary, if the patient limits himself to water, then favorable conditions are created for even greater reproduction of pathogenic microbes.

The liquids must include cranberry-lingonberry fruit drinks and compotes, herbal teas and still mineral water.

Conservative therapy

The approach to the treatment of patients is always individual and combined. Much depends on the duration of the existence and neglect of the disease.

To eliminate pathogenic microorganisms, agents with antibacterial and antimicrobial activity are prescribed. Antiviral medicines are used. Treatment continues for long courses, sometimes up to three or more months. The question of discontinuing such therapy is established by the results of several bacteriological studies of urinary sediment. If, according to the conclusion of crops, the pathogenic microflora is not determined, then the treatment is considered adequate and successful.

To combat the inflammatory component of the disease, anti-inflammatory medicines are used, which are used in tablets and in injectable form.

To improve trophic and regenerative processes, patients are prescribed therapeutic instillations, that is, drugs are injected through the urethra into the lumen of the bladder. This speeds up the healing of the organ and eliminates the inflammatory component.

The use of various folk remedies in the treatment of bladder leukoplakia is of secondary importance. Correctly combined herbs and their components have a beneficial effect on the functioning of the organ, normalize the act of urination and accelerate recovery. For these purposes, decoctions and infusions are prepared from the herb St. John's wort, ginseng, marigolds, oat grains, plantain root and other components.

Physiotherapeutic methods of treatment are aimed at correcting and restoring trophic processes, preventing adhesions and cicatricial growths. The patient is given sessions of magnetotherapy, electrophoresis with hormonal substances, microwaves and others.

Surgery

Indications for surgical intervention on the tissues of the bladder are:

• violations of the contractile activity of the organ, which are caused by long-term inflammation;
• according to the results of histological examination, there are morphological signs of stage 2-3 leukoplakia, or cellular atypia is detected, which threatens with cancerous degeneration;
• the patient has severe pain syndrome, which is difficult to treat with pain medications.

Thanks to TUR, the doctor can directly visualize the entire volume of the lesion and perform excision under the control of an endoscope

Considering the methods of surgical treatment, it is necessary to highlight the following procedures among them:

• Transurethral resection of pathological foci in the walls of the bladder (TUR). Patients enter a cystoscope into the lumen of the organ through the urethra. Areas of pathologically altered tissues are removed using a special loop. This type of intervention is a minimally invasive and highly effective method of treatment.
• The laser coagulation procedure is performed with a special laser device that removes only the superficial mucous layer from the bladder wall.
• The laser ablation method is also based on the action of a laser, but at the same time, the pathological formations are cauterized with an increased pulse power. The method allows the maximum effect on the affected tissues, while the healthy cells of the organ are practically not affected.

Prophylaxis

The basis of preventive measures aimed at preventing the development of bladder leukoplakia should include the sanitation and elimination of all infectious foci in the body.

Do not neglect the rules of intimate hygiene, all unprotected sex is excluded.

Practice sex with only a single, proven sexual partner

Pay due attention to rational and proper rest, protect yourself as much as possible from all conflicts and stressful situations.

Give up bad habits, maintain a healthy lifestyle, go in for sports and gradually temper the body.

If you have problems with the immune system, take strengthening medications and vitamin complexes.

Conclusion

You should not independently engage in treatment at home, while relying on the opinions of friends or information from unverified sources. Indeed, sometimes even doctors carry out complex diagnostics in order to establish for sure the nature of complaints and objective symptoms in a patient.

Always contact a specialist as soon as something bothers you. Only after consulting a doctor, it is necessary to start treatment, and not try to "drown" unpleasant symptoms by taking symptomatic medications.

The bladder (MP) is constantly strongly stretched. The organ is not injured during filling due to the presence of transitional epithelium. But the cells of this tissue are able to degenerate, which is why leukoplakia of the bladder often develops. Its symptoms are similar to urethritis, cystitis, or MP hyperactivity, so doctors do a thorough examination when the first symptoms appear.

What is Leukoplakia

The function of the transitional epithelium (urothelium) is to protect the walls of the bladder from the effects of uric acid and counteract the attachment of bacteria to the mucous membrane of the organ. But its cells can transform due to various factors, as a result of which metaplasia (tissue transformation) develops.

This is a kind of adaptation of the mucous membrane of the MP to functioning in new conditions, for example, the reaction of an organ to infection, inflammation.

If the reasons for the transformation are not eliminated at this stage, keratinization of cells begins. Keratinization of the transitional epithelium is called leukoplakia (derived from the words leuco and plakion - white plate).

Pathology has 3 stages of development.

1. I - the urothelium begins to transform into stratified squamous epithelium.
2. II - metaplasia develops, in which the diseased tissue is replaced by cells of a different histotype, but without keratinization.
3. III - at the site of the development of pathology, keratinization of the surface layer begins.

Dystrophic processes progress in the shell of the organ. As a result, the cells degenerate into squamous epithelium and keratinized. On the mucous membrane in the bladder, whitish or light plaques (spots) form, on which the tissue loses its elasticity, the ability to stretch and contract. Due to the loss of this function, a sclerotic process, inflammation occurs in the wall of the MP, and erosion may appear in places of keratinization.

Varieties of bladder leukoplakia

The disease is classified according to the place of development of the process. There are 3 types of pathology: leukoplakia of the bladder neck, MP body and urethra. But in women, it can also develop on the mucous membrane of the clitoris or vulva, and in men, on the head of the penis.

In addition, there are 3 types of urinary leukoplakia:

• flat;
• verrucous (warty);
• erosive.

It is possible to determine the form of pathology using instrumental examination and biopsy. Their results are taken into account when choosing treatment options.

Causes of bladder leukoplakia

Cell degeneration can develop as a result of defects that are laid even during the intrauterine formation of the epithelium. But most often leukoplakia occurs due to the penetration of infections into the bladder in an ascending or descending way.

In the first case, pathogens enter from the side of the urethra. With the ascending method, all infections that are sexually transmitted are considered the causative agents of leukoplakia. These are gonococci, chlamydia, papilloma and herpes virus, Trichomonas, other pathogens that cause diseases of the urinary and reproductive organs.

In the descending route, the infection enters the bladder cavity with blood and lymph. In this case, pathogens spread from nearby organs of the urinary, reproductive or digestive system. In the descending route, the causative agent is non-specific bacterial intestinal microflora (Escherichia coli and other enterobacteria), streptococci, staphylococci.

Predisposing factors

Pathogens can enter the MP from the kidneys, vagina, reproductive organs, intestines, as well as from remote areas in which there are infectious or inflammatory foci. Therefore, it is important to promptly treat all chronic diseases, even if it is stomatitis, caries or tonsillitis.

Other predisposing factors for the development of urinary leukoplakia:

• promiscuous sex life and refusal to use condoms;
• hypothermia;
• decreased immunity;
• frequent stressful situations;
• uncontrolled use of oral contraceptives;
• hormonal imbalance, increased estrogen levels;
• endocrine disorders associated with the functioning of the pituitary gland and hypothalamus;
• long-term use of an intrauterine device.

An abnormal structure of the urinary organs can also lead to pathology. Such defects are eliminated surgically.

Symptoms of leukoplakia in the bladder

With a flat form of pathology, signs of the disease may be absent, and in the case of the development of a warty or erosive form, they resemble cystitis or urethritis.

Symptoms of leukoplakia of the bladder, cervix or urethra:

• pulling pain in the lower abdomen, which increases with intercourse;
• urinary incontinence;
• frequent urge to empty the bladder;
• pain during urination;
• sometimes blood appears in urine, a precipitate in the form of flakes, and other impurities.

During an endoscopic examination, the doctor sees a change in the tissue. With flat leukoplakia, there are no elevations on the mucous membrane of the bladder, neck or urethra, the membrane in one or more places is covered with spots or it becomes cloudy. The warty form is characterized by the appearance of clearly limited plaques protruding above the level of healthy tissue. With an erosive form of pathology, wounds and cracks form on the mucous membrane.

Diagnosis of bladder leukoplakia

For a standard study, blood and urine are donated for a general analysis, as well as a sample according to Nechiporenko. For bacteriological examination, the doctor makes smears in women from the walls of the vagina, cervix, and in men - from the urethra.

Laboratory analysis of biomaterial:

• identification of pathogens by PIF, ELISA or PCR;
• determination of the level of urea, creatinine in a biochemical blood test;
• assessment of the components of the immune system using an immunogram.

The laboratory technicians also determine the sensitivity of the inoculated pathogens to the effects of antibiotics.

Hardware diagnostics of leukoplakia:

• Ultrasound of the kidneys, bladder, pelvic organs;
• cystometry, uroflowmetry;
• cystoscopy followed by a pinched biopsy.

Therapy for urinary leukoplakia

Depending on the stage of the pathology and the area of ​​the membrane lesion, doctors use complex conservative methods and physiotherapy, less often - surgical intervention. The patient is also advised to eat food that does not irritate the walls of the gastrointestinal tract, does not cause an increase in the concentration of urea in the urine.

Treatment of bladder leukoplakia is complex. For the destruction of pathogens, Norfloxacin, Lefloxacin, Ciprofloxacin, and other antibiotics are used. To relieve inflammation, nonsteroidal anti-inflammatory drugs are prescribed. To improve immunity, take Lavomax or other immunomodulators. To reduce the irritation of the walls of the MP with uric acid, the patient is irrigated with the bladder membrane with Heparin and Chondroitin sulfate through a catheter.

Conservative treatment is complemented by electrophoresis, laser and magnetotherapy. Physiotherapy improves tissue trophism and cell regeneration. If the use of these methods is impractical, doctors perform an operation.

Surgical treatments for leukoplakia:

• transurethral resection (TUR) of the bladder;
• laser coagulation (cauterization) of the mucous membrane of the MP;
• laser ablation (rejection) of damaged tissue.

After surgery, the symptoms of leukoplakia disappear within 7-10 days. Doctors also allow the use of folk remedies in addition to the main method of treatment. Helps relieve inflammation herbal tea with calendula and St. John's wort. But before using them, you need to familiarize yourself with the contraindications of phytopreparations.

Doctors also recommend simple prevention of leukoplakia: maintain immunity, maintain hygiene and use condoms during sex. These measures prevent the spread of bacteria through the genitourinary system.

Complication of leukoplakia

The course of the disease is aggravated by the fact that the walls of the bladder become sensitive to the effects of uric acid. This provokes constant irritation of the organ membrane, which causes the development of chronic cystitis. Another complication is urinary incontinence. It arises due to the formation of sclerotic areas in the wall of the MP, which interfere with the normal functioning of the organ. In the future, cystitis and incontinence can provoke kidney failure.

Leukoplakia of the urethra often leads to narrowing of the lumen of the canal, which makes it difficult to urinate and causes congestion. Continuous irritation of its walls provokes relapses of urethritis or the formation of erosions on the mucous membrane.

In 25% of clinical cases, the tissues affected by leukoplakia become malignant, that is, the cells are reborn into cancerous ones, which is why the development of pathology is regarded by doctors as a precancerous condition. Therefore, all methods of treatment are aimed at destroying keratinized plaques and the causes of their formation.

Conclusion

Leukoplakia is a latent disease that is complicated by life-threatening pathologies. The pathological process occurs on all mucous membranes, where there is a transitional or stratified squamous epithelium. Bladder leukoplakia can only be detected by instrumental and cytological examination, so it is important not to miss scheduled examinations, especially for people after 38-40 years.

Leukoplakia- This is one of the diseases that is quite common. It can occur in people of any age, but most often middle-aged and elderly females are prone to pathology.

The data regarding the time of occurrence are ambiguous, in most cases this is due to the fact that young people are less likely to undergo examinations, in which there is a possibility of accidental detection.

Pathology is characterized by damage to the mucous membranes of various organs. As a result of leukoplakia, stratified squamous epithelium acquires a horny formation. Against the background of this process, a grayish or white formation appears on the mucous membrane.

The most common target organs are the mucous membranes of the oral cavity, upper respiratory tract, as well as the genitourinary tract and anal region.

Special attention should be paid to leukoplakia, and this is due to the fact that in almost a quarter of all cases, the disease can flow into a malignant process. Therefore, when such a situation is identified, a thorough examination should be carried out and the state and dynamics of the process should be regularly monitored.

Leukoplakia concept

This disease is considered to be chronic and this is due to the fact that its development is usually long, including several successive stages, while, as a rule, does not disappear on its own.

From a morphological point of view, a process occurs when the transitional epithelium of the mucous membranes is replaced by a flat one.

As a result, at the cellular level, the following transformations can be noticed, this is the absence of glycogen formation, the formation of the stratum corneum, which normally should not be on this type of tissue.

This disease causes great concern among doctors due to the fact that the exact causes, complications and factors contributing to the formation are not fully understood.

Therefore, patients who have been diagnosed with bladder leukoplakia are recommended to carefully monitor and constantly monitor the course of the process in order to exclude the development of complications.

There are several types of classification of bladder leukoplakia, all of them based on various characteristics of the pathological process.

Depending on the localization of the disease, two forms can be distinguished:

• Bladder neck leukoplakia is one of the most vulnerable places, and, therefore, the most common form.
• The body of the bladder becomes affected.

In the development of the lesion, several regular phases of the course can be distinguished:

• Initial stages of development. Focal replacement of fragments of the mucous membrane in areas with squamous epithelium.
• Second phase. Squamous metaplasia. It is characterized by the fact that the normally existing single-layer columnar epithelium is replaced by a denser and less vulnerable multi-layered epithelium.
• Stage three. It is associated not only with structural, but also functional changes in the organ. As a result, the epithelium covering the walls undergoes cratinization, it becomes denser, the elasticity of its walls is lost, and as a result, the full-fledged process of urine evacuation from the organ is disrupted.

Among the diseases of the bladder, several types of pathology can be distinguished:

Causes of bladder leukoplakia

1. The main predisposing factor is the infectious factor. This also explains the fact that it most often affects the mucous membranes of the urogenital tract of women. The representatives of this sex have features in its structure, the urethra is somewhat shorter and wider than the male. Consequently, the risk of penetration of pathology is much higher. Any inflammatory lesion, especially a chronic one, which causes a change in the mucous membrane. These include mainly, and.
2. Also, one of the reasons is considered to be a viral infection represented by the human papillomavirus. It affects the bladder in a hematogenous way. In some cases, inflammation can be transmitted through the lymph.

For the development of such reasons, the influence of provoking factors is necessary.

Among them are:

Bladder leukoplakia symptoms

Symptoms are as follows:

Diagnostics of the leukoplakia of the bladder

In some cases, such activities can be complicated by latent symptoms, as well as a long period of progression. Often the disease is established at the stage of pronounced changes, which is accompanied by various complications.

Diagnostic steps:

Complications and consequences

Scientists have identified a pattern that this disease rarely turns into a malignant process, in order for this to happen, many other pathogenic factors must affect the body, and there must also be a high predisposition to the oncological process. The course of leukoplakia itself is not prone to malignancy processes. Therefore, only in rare cases does the disease turn into cancer.

Complications:

1. The main complication developing against the background of this pathology is a violation of the functionality of the bladder. The filling function is lost, as well as full emptying. With the development of the latter, there is an excessive accumulation of urine in the bladder and the contents are thrown into the ureters. A similar condition provokes the development of an ascending infection, leading to the formation of pyelonephritis.
2. Almost all people with bladder leukoplakia develop chronic renal failure. A serious illness that requires compulsory treatment.

Bladder leukoplakia during pregnancy

Leukoplakia affects the course of pregnancy and can lead to the development of serious complications.

Since such a disease leads to inflammatory processes that involve neighboring organs.

No inflammation, especially associated with a specific pathogen, requires compulsory treatment.

This is especially dangerous in the early stages of pregnancy, since the pathogen without treatment can lead to the development of fetal pathology and anomalies in the structure of the placenta and umbilical cord.

But on the other hand, treatment with specific antibacterial and antiviral drugs can also affect the course of pregnancy.

Early leukoplakia can affect the development of fetal abnormalities and placenta formation. With a pronounced course of the process, there may be a threat of miscarriage or a frozen pregnancy.

In late pregnancy, there is a threat of placental insufficiency, premature birth, intrauterine growth retardation and the formation of intrauterine infection. The latter pathology leads to the development of polyhydramnios, isthmic cervical insufficiency, etc.

Treatment during this period requires capable attention, since there is a high probability of the harmful effects of drugs on the child. Therefore, the beginning of therapy is selected taking into account the severity of the pathological process, as well as the factor affecting leukoplakia.

Specialists prescribe the main therapy after delivery, taking into account the accompanying processes. If a woman is diagnosed with leukoplakia at the time of pregnancy planning, then full treatment is required before it occurs. During therapy, it is recommended to use contraceptive methods.

Bladder leukoplakia treatment

Conservative remedies

These methods of treatment act as the first line of drugs used for leukoplakia. It is always recommended to start therapy with medications, but if ineffective, they resort to surgical ones. Conservative medicine can be combined with traditional methods to improve the effect.

Preparations:

Surgery

The operation is used as a method against the background of the ineffectiveness of conservative therapy, as well as the development of complications.

This could be:

• Coagulative methods of removing the affected mucous membrane (electrocoagulation),
• Laser ablation options (laser cauterization)

Treatment of leukoplakia with folk remedies

Includes primarily herbal preparations. The mechanism of their action should be based on the provision of anti-inflammatory and sensitizing effects on the surface of the mucous membrane, helping to cure and prevent the inflammatory process.

The following components have similar effects:

Diet for leukoplakia of the bladder

The main principle in the prevention and prevention of the development of pathology is to reduce the irritant effect on the mucous membranes.

Prophylaxis

Includes: