Mild cases are often characterized by sudden hematuria, which may be accompanied by frequent and urgent urination. Cystoscopy reveals pale and thin mucosa, reduced bladder volume, brittle small blood vessels, and sometimes bleeding from ruptured small vessels. When hematuria occurs, there are often triggers, such as straining and holding urine. It can be cured by itself without treatment, or with hemostatic agents. When the amount of hematuria is large, cystoscopic electrocautery and laser hemostasis can be used.
Moderate recurrent or persistent intractable hematuria with urinary urgency, frequency and pain. Repeated bleeding and clots in the bladder can lead to urinary retention or compression and obstruction of the ureteral orifice causing ureteral obstruction. Cystoscopy shows small bladder volume, bladder contracture, loss of bladder wall elasticity, congestion, edema, erosion, ulceration, necrosis, vasodilatation and bleeding. This condition should be actively treated with the following principles: 1. Keep the ureter open for a long time to maintain the bladder void; 2. Bladder irrigation to avoid accumulation of blood clots in the bladder; 3. Hemostasis, either oral or injectable hemostatic agents (see proctitis), and electrocautery or laser hemostasis under cystoscopy; 4. Anti-inflammatory: use urinary tract antibacterial agents such as penicillin, cephalosporins, furantin, sulfonamides, haloperidol; 5. Chinese medicine: the following herbs can be used in combination with evidence, such as licorice tip, cynomolgus leaf, mucuna pruriens, psyllium, chrysanthemum, cypress, white foxglove, large and small thistle, liuyi san, gardenia, etc.; 6. rest and drink more water.
Severe vesicovaginal fistula, often arising on the basis of the above-mentioned bladder lesions. No special effective treatment is available. Cystostomy is not ideal to solve the problem of urinary leakage, and it is difficult to estimate the pros and cons of other substitution bladder surgery for patients. However, experience has shown that if the leakage problem is not resolved, long-term survival can be achieved with proper care.