Doctor: It's reasonable to perform surgery on yourself.
Chapter 468 Rare! Incurable disease!
The previous urinary tract CT, MRU, and several common laboratory tests showed no obvious abnormalities.
There were no problems with the upstream kidneys, and there were no positive symptoms such as stones in the descending ureters, so Xu Qiu targeted the bladder.
But this time, the new electrical stimulation of spinal reflexes finally discovered the problem.
The examination showed that the spinal reflex arc nerves in Xun Yu's bladder and urethra were incomplete, the lower motor neurons were pathologically damaged, and the detrusor muscles had no reflexes. This caused the bladder to lose its basic functions of storing urine and urinating.
Xu Qiu hurried to Xun Yu's ward. At this time, her parents had already arrived. They were two well-behaved old people who seemed to be professors from a nearby university.
"Doctor Xu!"
Xun's father obviously knew Xu Qiu, and his originally worried face suddenly broke out into a smile: "If you are the one who treats my little girl, then I will feel relieved."
Xun's mother was a little surprised. Her husband was a staid old man and was very wary of outsiders. How come he breathed a sigh of relief the first time he saw this doctor?
"Doctor, you are here!" Xun Yu was also very happy.
Xun's mother was puzzled again. She knew her daughter, who had raised her for more than 20 years, since her grandmother who loved her passed away due to a missed diagnosis by a doctor. She was full of hostility towards all doctors and would not come to the hospital unless absolutely necessary.
Why does she trust Dr. Xu so much?
"Well, I'll do a few more tests."
Xu Qiu pulled up the screen, put on gloves, and then gently pressed on the front of Xun Yu's pelvis and lower abdomen.
"No, don't!" Xun Yu's expression suddenly changed, and then a flash of red quickly flew across his face.
Xu Qiu realized what had happened and continued to ask calmly: "Do you feel anything?"
"Yes...I, I did that again..." Xun Yu's eyes dodge.
"Do you usually have the urge to pee?"
"Yes, why not?"
"What does it mean to have something?"
"It's just... I have this problem, so I don't dare to wait until there is time to go. I always go to the toilet every ten minutes or half an hour, whether I want to or not. In this way, even if I get sick again, The quantity won’t be too big.”
Xu Qiu took off his gloves and finally solved the case this time.
Even if he meets a patient, it is impossible for him to consult everything.
For example, the urge to urinate.
At that time, he also conducted a routine consultation, but learned from Xun Yu that his urinary habits had not changed significantly from before, and there were no symptoms such as urgency or frequent need to urinate.
However, the focus is exactly on the need to urinate!
She thought it was because she urinated regularly and therefore rarely had the urge to urinate, so she subconsciously ignored this information.
In fact, she had long since lost the feeling of bladder distension and could not feel the urge to urinate at all!
"Look, can you tell what the disease is?" Xun Yu pulled the quilt and covered it on his stomach.
Xu Qiu nodded: "Neurogenic bladder."
"What kind of disease is this?" Xun Yu's parents' expressions changed slightly when they heard this unfamiliar terminology.
However, nerves and bladder don't sound like uncommon words, so they shouldn't be too serious.
But Xu Qiu's next words made the three of them change their minds.
"There is currently no cure for this disease."
"ah?!"
Xun Yu's face turned pale immediately. She felt that the world suddenly turned dark. Her hands and feet were cold and her whole body felt weak. If she had to wear thick diapers from now on and worry about incontinence all the time, such a life would be worse... If you get cancer, at least you will die happily!
Diseases that are incurable, incurable, and torture people all the time are the most despairing.
Xu Qiu was also a little helpless.
Neurogenic bladder is a kind of damage to the central or peripheral nervous system, resulting in vesico-urethral dysfunction, urinary obstruction, urinary retention, or urinary incontinence, which may be symptoms.
The international community does not have a unified classification for it, but it can be roughly summarized according to the location of the disease as detrusor hyperreflexia in upper motor neuron lesions and detrusor no reflexes in lower motor neuron lesions.
There are too many pathogenesis mechanisms and they are related to the central nervous system, such as cerebrovascular accidents, brain tumors, ataxia, and the rare multiple sclerosis;
Peripheral nerve damage can also be caused by diabetes, alcoholism, or drug abuse.
Of course, clinically it is also commonly seen in patients with acquired immunodeficiency syndrome, that is, AIDS patients.
Medicine is an empirical discipline, and there are too few diseases for which the truth can be found. Human research on the mechanism of neurogenic bladder still has a long way to go.
"Is it really impossible to cure it?"
After a few minutes of silence, Father Xun's voice seemed to have aged for a moment, and his originally sparkling eyes gradually dimmed at this moment.
"The main purpose of treatment for neurogenic bladder is to protect the function of the upper urinary tract and prevent the occurrence of pyelonephritis, hydronephrosis or chronic renal failure... The good news at the moment is that the patient has no urinary tract infection and no upper urinary tract infection. There was no apparent damage.”
The commonly used clinical method is actually similar to what Xun Yu did before, which is intermittent catheterization. This can effectively treat neuromuscular urinary dysfunction, while avoiding the pain of wearing a urethral tube for a long time and avoiding suprapubic cystostomy.
The international community has also proposed drug treatment methods.
Such as taking drugs to treat detrusor weakness, such as M receptor agonists, or finding ways to reduce bladder outlet resistance, such as taking α receptor blockers, or even using desmopressin to directly reduce urine production--
Since the problem cannot be solved, then solve the trouble that caused the problem.
Of course, these measures are not thorough enough, such as intermittent catheterization or drug treatment, which can only reduce urinary tract complications and improve bladder compliance and capacity to a certain extent, but cannot touch the essence of the disease.
Unfortunately, Xun Yu still has a neurogenic bladder of the lower motor neuron type...
The medical community has developed closed therapy in recent years, which can significantly reduce residual urine volume and significantly improve the patient's urination disorder. A single treatment can last for several months to a year, and regular closed therapy is basically the same as normal people.
However, the problem is that closed therapy is only applicable to upper motor neuron lesions, that is, the classification of detrusor hyperreflexia, and Xun Yu happens to be the type without reflexes.
"Try non-surgical treatment first." Xu Qiu said.
Xun Yu's eyes were swollen from crying. She sniffed, wiped her eyes, raised her head and asked, "What if it doesn't work? What should I do?"
"Then we can only consider surgery."
"Surgery... Doctor, didn't you say that the muscle has no reflex? Does the surgery need to replace a reflex muscle?"
Xu Qiu shook his head.
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