Effect of anti-ischemic therapy on the recovery of bladder function after acute urinary retention. Restoring Bladder Functions with Nerve Regeneration

The bladder after any operation needs special care to ensure its normal functioning in the future.

Bladder

Indications for surgical intervention on the bladder can be diseases of the mucosa or its walls, the presence of malignant tumors or stones, all kinds of anomalies caused by injuries.

bladder operation

Surgical interventions are indicated only when medical treatment has not brought the desired results.

There are two types of operations that differ in the degree of access to the operated organ: minimally invasive and open.

Open surgery is a type that involves abdominal surgery, an incision is made on the abdominal wall.

Minimally invasive (endoscopic) operations are characterized by less intervention in the human body.

Thanks to modern advances in the field of medical equipment, the operation is carried out by inserting special miniature devices into the urethra or vagina in women.

The TUR operation is widely used, which, along with minimal invasiveness, is also characterized by minimal trauma.

Such surgery prevents major bleeding, reduces the risk of infection and subsequent complications. In addition, the recovery period is short.

To improve the efficiency of TURP, it can be combined with simultaneous other types of resections, which include laser, photodynamic, electrocoagulation.

The bladder often suffers from the appearance of stones in it. Therefore, after medical treatment that has not brought improvements, doctors suggest transurethral or percutaneous cystolitholapaxy, as well as cystotomy.

The most sparing is transurethral cystolitholapaxy, which allows crushing stones and removing them from the bladder using a cystoscope without making abdominal incisions.

The other two operations involve incisions because the stones in the bladder are large. Between themselves, percutaneous cystolitholapaxy and cystotomy differ only in the size of the incision.

Unfortunately, the reason for an operation on the bladder can be malignant tumors that affect the mucous membrane and walls of this organ.

Oncosurgeons prefer the use of TUR, as well as the method of transurethral laser coagulation, when the tumor is removed with a laser.

In some cases, the patient is offered a partial cystectomy, in which the affected part of the bladder is removed.

Carrying out cystectomy is possible provided that the tumor spreads over a small area of ​​the bladder, as well as the absence of its transition to neighboring organs.

When carrying out such an operation, there is a need to open the bladder itself.

Possible Complications

After any surgical intervention, various complications are possible.

acute pain

Bladder surgery is no exception, so almost immediately or after a certain amount of time, the patient experiences the following complications:

• bleeding;
• urinary streaks;
• acute pyelonephritis;
• urosepsis;
• bacteremic shock;
• urinary retention.

A fairly common complication is cystitis, which is characterized not only by painful urination, but even by the almost impossibility of its implementation.

This is due to a violation of the contractile function of the bladder.

Its dysfunction may be temporary, but, unfortunately, there are facts when the bubble is not able to perform its functions for a sufficiently long period of time.

Disorders of the functions of the bladder lead after surgery to the development of urinary infections with tissue damage and the formation of fistulas.

Difficulty urinating occurs in 45% of patients, urinary infection in 31%, and fistulas in 1%.

Despite the fact that modern medicine is actively developing, new methods of treatment and operations are emerging, the problem of the formation of urinary fistulas after surgery is still relevant, since it causes many problems for the patient.

A fistula that occurs after an operation brings not only physical, but also moral suffering, because due to such a disease, urine and an accompanying unpleasant odor are constantly released.

Antibacterial therapy

Bleeding after bladder surgery often occurs immediately and is characterized by the presence of blood in the urine itself. But bleeding can open after 10 days.

For primary and secondary bleeding, conservative treatment is indicated, including the application of cold, blood transfusion and the appointment of special hemostatic drugs.

If such treatment does not bring tangible results, then an urgent reoperation is performed.

The use of modern antibiotics allows in most cases to avoid the occurrence of inflammatory processes that affect the bladder.

However, there are still isolated cases of manifestation after operations of urosespis, characterized by sharp changes (rise and fall) in temperature, severe chills.

The patient is indicated for immediate antibiotic therapy, with its poor effectiveness, an urgent reoperation is indicated.

A frequent postoperative complication on the bladder is the formation of a hernia, which is inherent in almost any abdominal operation.

And the most insidious complication is the relapse of the disease.

Recovery

Each patient the next day after the operation receives recommendations that, if strictly followed, will quickly restore a weakened body and prevent complications.

At the same time, any load in any form is absolutely contraindicated for the patient. The “injured” bubble, or rather its walls and the walls of the abdomen, should get stronger.

In addition to taking medications prescribed by a doctor, phytotherapy shows good results.

Medicinal herbs are characterized by anti-inflammatory, wound healing and diuretic actions.

An infusion made from juniper berries, celandine, violets and horsetail is incredibly useful for operated patients. It is useful to eat parsley and dill.

The excellent combination of St. John's wort, chamomile, bearberry and knotweed also brings great benefits for a speedy recovery.

The patient is obliged to control food intake and strictly adhere to the prescribed diet.

Phytotherapy

Food should be necessarily only easily digestible. Fatty foods and rich in coarse fiber are excluded. Preference is given to liquid or semi-liquid consistency of dishes.

It is impossible to allow an increase in the acidity of urine, in connection with this, marinades, sour fruits and juices from them, as well as fermented milk products are prohibited. The consumption of alcohol, especially wine and beer, is prohibited.

The bladder will "thank" its "owner" for special efforts during recovery after operations.

In many ways, the result of treatment, its effectiveness depends on the efforts of the patient, his faith in a complete cure.

The bladder is an organ that requires increased attention and care, especially when it has been operated on.

Living happily means taking care of your health and avoiding serious problems.

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User comments:

Why acidification of urine is contraindicated after abdominal surgery?

It is a pity that this article caught my eye so late. I would have known that persistent swelling of the bladder is a normal postoperative phenomenon.

I had bladder stones removed, after the operation I recovered quite quickly, and I am on a special diet now so that stones do not appear again.

Now it is worth doing better minimally invasive operations, then recovery will take less time. Spare no money.

A day after the operation, I started bleeding, they applied cold. It's good that everything worked out.

He underwent surgery to remove prostate adenoma. Accordingly, there was an operation with the bladder. Subsequently, there were problems with normal urination for a long time. It is necessary after the operation to ask the doctors very well about the condition of the internal organs. I had a problem after the operation because other organs were lowered, which put pressure on the bladder and made it difficult for it to work. Yes, and you yourself need to listen to your body, what signals it gives, then recovery after the operation will be a great success.

TUR operations are not as safe with our doctors in ordinary hospitals. It is better to find a specialist and pay more than in ordinary clinics.

Tell me, the temperature is the third day after the operation. This is fine? I'm worried about my grandfather.

I had a round of bladder surgery. All mucosa and papillomas have been removed, the main struggle is to exclude cancerous papillomas and prevent formation.

I have chilblains and cystitis. Today is day 8 after surgery.

I had an operation to lower the bladder, they sewed it up to me. Now I have urinary incontinence! It has been 10 days since the operation.

Tell me, they removed a tumor on the bladder and after a while the lower back began to hurt, the urine turned red! What can be wrong?!

I had a bladder neck tour. On December 5, I already had time to bougie once after that, and now I am lying with a catheter. I couldn't urinate, I don't know why. Walking outside, it might be cold. So take care of yourself!

Hello, I do not know if it is possible to ask a question here, but still I hope for your help. I'm 32 weeks pregnant and we've been diagnosed with double bladder. How to deal with this and how surgeons can help us? I'm afraid for the child, they said surgery is possible.

Hello! Tell me, yesterday they had an operation, everything seems to be fine, but the temperature is 3 days old! It started even before the operation the day before, it was 37 and now 37.9

Good afternoon! Two months ago, I had an abdominal operation to remove a stone driven into the back wall of the bladder near the exit. Together with the stone, the mucus that had formed around the stone was removed and the exit from the bladder was possibly cleaned. Mucus tests are negative. The analyzes showed that I have a reduced ability to restore the epithelium of the cells of the operated surface of the bladder. To date, there is no blood in the urine. But there were sensations of overflow of a bladder and frequent desires (every hour). At the end of urination, burning in the canal. To completely empty the bladder, you have to push several times. Temperature 37.1 during the day. In the evening it rises to 38. Question. What medications, maybe antibiotics, can be taken to relieve these symptoms and temperature. Thanks in advance for your reply!

2 goals have passed since the operation to remove the uterus and suture the bladder. Everything was fine, but something happened yesterday. Arrived at work just wet (drop-shaped incontinence). I use sanitary napkins, I made an appointment. I don’t know how this will all be treated and is it treated? I’m very scared, I don’t want to live, but I’m only 57 years old ...

How to remove the pain from the urge to urinate?

Hello! I had an operation - they removed the bladder and the left kidney with the ureter. The ureter is brought out into the abdomen. Could you tell me, please, which catheters are better to use?? I am currently using a two-way Foley catheter.

Can you add something?

Using new technology to stimulate the regeneration of nerve cells at the site of a severe spinal injury, researchers restored bladder function in paralyzed adult rats, according to a study published June 26 in The Journal of Neuroscience. The findings may guide future efforts to restore other functions lost after spinal injury. They also offer hope that a similar technique could one day be used to restore bladder function in people who have suffered a severe spinal injury.

For decades, scientists have been experimenting with the use of nerve grafts as a method of connecting the spinal cord at the site of injury in an attempt to restore lost function after injury. However, it was almost impossible to "persuade" these cells to grow and form connections capable of transmitting nerve impulses. In the present study, Yu-Shan Li, Ph.D., of the Cleveland Clinic, along with Jerry Silver, Ph.D., of the Case Western Reserve University School of Medicine, as well as other scientists, applied a chemical that stimulates cell growth, along with an enzyme against scars to create a more favorable environment for transplanting the nerve graft to the site of injury.

“While the animals did not regain the ability to walk, they regained much of their bladder control,” explains Silver. This basic function is one of those that spinal cord injury patients find most important to recover.

For the first time, bladder function was restored after a devastating spinal cord injury by nerve regeneration.

When a spinal cord injury occurs, branches of the nerve cells in the brainstem—the area of ​​the brain where the signal to urinate comes from and where the process is coordinated—lose connection with the cells in the spinal cord that control contraction and relaxation of the bladder and open and close the urethra. The natural reaction of the body in the form of scarring at the site of injury reduces the spread of inflammation, but prevents the growth of individual nerve fibers. Therefore, in the absence of the possibility of restoring communication between the brain stem and spinal cord.

Trauma often results in a temporary inability to empty the bladder.

When performing an operation to transplant nerve grafts into the site of an injury, the researchers injected rats with an enzyme called chondroitinase to prevent scarring, and a chemical called fibroblast growth factor, used to promote cell survival. After six months, the scientists found that the rats that received this combined treatment had a significant recovery in bladder function, as indicated by diuresis assessment. The researchers also noted the regrowth of some brainstem cells at the site of the injury.

Certain nerve cells located mostly in the brainstem, can slowly grow back down to the spinal cord if they are provided with tolerable conditions that allow them to overcome the scarring site.

“What gives these special neurons such a natural ability to re-grow is not known, but this will be an extremely important area of ​​research in the future,” says Silver.

Elizabeth Bradbury, Ph.D., a spinal cord injury researcher at King's College London, who was not involved in the study, warns that several challenges must be overcome before such a therapy can be tested in humans. “However, this remarkable achievement gives people great hope for the possibility of future recovery of bladder function from spinal cord injury,” she says.

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What are the causes of bladder loss? What are the ways to help patients without a bladder? What does a patient need to know about bladder repair surgery? What are the benefits of Oncourology NCG in Bladder Reconstruction Surgery?

What are the causes of bladder loss?

Loss of the bladder... There are 2 big reasons for this: oncological diseases, when the bladder must be removed to cure the patient, and benign diseases, leading to bladder shrinkage or microcystis. In the first case, it is cancer of the bladder, gynecological organs or rectum, when the oncologist is simply forced to remove the pelvic organs, including the bladder. In the second case, it is interstitial cystitis, a little-studied disease that leads to shrinkage of the bladder - a sharp decrease in its volume. Both the first and second cases are a nightmare for the patient: if his ureters are exposed to the skin, then he is forced to live with bags where urine constantly flows, and if he has a microcyst, then he is forced to urinate 50-60 times a day. There is no need to talk about the quality of life. In all these cases, it is necessary to restore the bladder.

How is it possible to restore the bladder?

The bladder is a reservoir. If it doesn't exist, it needs to be created. Modern reconstructive surgery makes it possible to create a new reservoir from a segment of the intestine. In essence, we take a section of the intestine, sew a ball out of it, with which we connect the ureters and the urethra. It turns out the bladder.

-Those. urine enters the intestines?

No way. The segment is completely isolated from the intestine. Imagine that you have a tube 3 meters long. You took and cut off a section from the middle of this tube 50 centimeters long, and sewed the side sections together. You will have an isolated tubing segment and a complete tubing with no connection to the segment. It is from this isolated segment that we will recreate the bladder.

What should a patient know who is indicated for bladder reconstruction?

Usually, we first examine the patient in detail. After all, the bladder can only be restored from a segment of the intestine. It is necessary to understand whether the intestines are healthy, the success of surgical treatment depends on this. Unfortunately, other methods of bladder reconstruction are experimental in nature and have not entered clinical practice. The second aspect: reconstructive surgery is almost always a multi-hour operation, therefore, before offering such an intervention to the patient, we examine the cardiovascular, respiratory and nervous systems, thus guaranteeing the patient's safety. Of the negative aspects, I would note the need to put pressure on my stomach to urinate after the operation. Unfortunately, the wall of the intestine cannot contract like the wall of the bladder. However, this minimal inconvenience does not spoil the quality of life, while the need to be constantly in the toilet, or carry two bags - a urinal, live under the threat of chronic renal failure, depression ... Perhaps it is better to press on the stomach when urinating.

— What are the advantages of Urology Oncology GCG in bladder recovery?

We are an interdisciplinary team of specialists with extensive experience in reconstructive surgery. Our clinic is equipped with modern equipment, both surgical and anesthetic and resuscitation, which makes it safe to carry out many hours of reconstructive interventions. But, perhaps, our main advantage, the quintessence of our philosophy is that we are always close to the patient.

- an effective invasion that helps a person get rid of complex chronic diseases or cancer. Many patients come to Israel because high-class urologists work with them here. Other reasons are the weighted prices for hospital services, modern equipment and the use of the most effective techniques.

If the patient seeks help in a timely manner, the surgeon partially dissects the bladder. In other cases, the clinic will offer him an operation with the reconstruction of the bladder from artificial materials. The prices for removal and reconstruction of the bladder, as well as any other procedures in Israel, are among the most affordable compared to countries such as the USA, France or Germany, so patients from all over the world come here.

Innovative examination methods before removal and reconstruction of the bladder in Israel

Before the intervention, the patient is waiting for a detailed examination, which will help the doctor make the correct diagnosis and perform the operation as accurately as possible.

Diagnosis of the bladder in Israel consists of:

• detailed clinical blood tests;
• ultrasound examination of internal organs;
• computed or magnetic resonance imaging - according to indications;
• radiography;
• cystoscopy;
• consultations of a urologist, an anesthesiologist and other doctors of related specializations.

The main indications for such an invasion are: bladder or prostate cancer, the malignant cells of which have metastasized into the bladder. As well as nervous diseases, injuries, congenital anomalies.

The latest methods of removal and reconstruction of the bladder

Surgeons can achieve high efficiency with minimal trauma to human organs and tissues through impressive laparoscopic capabilities, as well as using robotic technology.

Bladder surgery is performed under sterile hospital conditions, so such negative aspects as infection, blood poisoning, and the development of an inflammatory process are completely excluded. Thanks to the professionalism and experience of urological surgeons, postoperative disorders in the functioning of the genitourinary organs are minimized.

The most sparing methods in clinics for the removal and reconstruction of the bladder in Israel include minimally invasive intervention, which is carried out through the urethra and does not require large-scale abdominal incisions. The operation, during which a fragment of the bubble is removed, is called cystectomy. The restoration of the organ is performed by the patient's own tissues (small or ileal intestine).

If there is a need complete organ recovery, the surgeon creates a urostomy through which urine enters a separate outer plastic container. Also, a kind of cavity for collecting urine, located inside the human body, can be created from intestinal tissues. It is emptied through a catheter in the lower abdomen.

The most comfortable for a person is bubble made of artificial materials. The excretion of urine from it occurs by tension of the muscles of the press in a natural way. Despite the effectiveness of the course of therapy in Israel, the cost of removal and reconstruction of the bladder is reasonable, as it is controlled at the level of the Ministry of Health.

Doctors' answers to patients' questions

1. I was refused in the hospital for the removal and reconstruction of the bladder, what could be the reason?

This surgical invasion is quite extensive and requires a long recovery. According to the physical condition of the body, patients who are over 70 years old, as well as patients with diabetes mellitus, cardiovascular and other serious diseases of a chronic nature, cannot transfer it.

1. How will I feel after bladder repair surgery?

According to reviews after removal and reconstruction of the bladder, it can be concluded that most patients feel good while undergoing rehabilitation. The functions of erection and urination are gradually restored.

1. How often will I need to see a urologist after surgery?

Since the patient underwent a complex operation, his state of health needs long-term monitoring. So, quarterly it will be necessary to donate blood for biochemical analysis, undergo an ultrasound examination and check the functionality of the kidneys. Then the number of inspections is reduced to two per year.

Contact the staff of NewMed Center - restore the vital functions of the body!