Chronic ulceration in bilharzial bladder

ABSTRACT

Chronic ulceration m bilharzial bladder is not an uncommon complication of bilharzial cystitis. 154 cases of chronic bilharzial ulcer and were studded clinically. The ulcers are classified according to their naked eye appearance. 96 cases were operated upon, 23 by simple excision and 73 by partial cystectomy. Bilharzial bladder nock obstruction which was a common association [79%] was corrected surgically. Operative specimens of 40 cases were described histopathologically. Different lines of treatment are attempted and their results are evaluated. Medical treatment is not effective except occasionally. Trans-uretheral cauterisation is always a failure. Partial cystectomy gives better results them simple excision of the ulcers. The possible causes of recurrence of ulcers are discussed. Uretrosigmoidostomy or ileocystoplasty is recommended for cases of recurrent ulcers with contracted bladders. Pathological study of the resected ulcers helped to eluctidiate same aspects of the clinical picture and the different responses to various lines of treatment. 154 cases of chronic bilharzial ulcers were studied clinically. The ulcers were classified according to their naked eye appearance. 96 cases were operated upon, 23 by simple excision and 73 by partial cystectomy. Bilharzial bladder neck obstruction which was a common association [79%] was corrected surgically. Operative specimens of 40 cases were described histopathologically. Different lines of treatment were discussed. Medical treatment was not effective except, occasionally. Transuretheral cauterisation was always a failure. Partial cystectomy gave better results than .simple excision of the ulcer and a simple technique of partial cystectomy is described. Uretero-sigmioidostomy or ileocystoplasty was recommended in cases of recurrent and multiple ulcers with contracted bladders. Pathological study of the resected ulcers contributed to the understanding of the pathogenesis and clinical picture and the different responses to different lines of treatment