There is a bladder infection different from acute cystitis that lesbians are most likely to get, did you know that? Let me explain: As far back as 1887, Professor Von limbeck first described a bladder infection in which the mucous membrane in the open bladder was a patch of follicles. It was not until 1979 that a Wiener pathologist observed the bladder in 100 cadavers aged 12 days to 101 years and made a detailed pathological diagnosis that the concept of “adenocystitis” was clearly introduced. This is an autopsy pathology, so what is the actual clinical situation of adenoid cystitis? The medical finding is that there are more women with adenocystitis than men, with a male to female ratio of 1:5. The detection rate for outpatient cystoscopy is 27% to 41%. This is not a small group! It is well known that women are prone to urinary tract infections. However, if there are recurrent urinary tract infections or if this history persists for many years, it can easily evolve from a common cystitis to an adenoidal cystitis. The clinical presentation of adenoid cystitis is basically the same as that of common cystitis, and both may present with urinary frequency, urgency, painful urination, and hematuria; difficulty in urination; and often with pain in the lower abdomen or perineal area. Some patients will show a decrease in maximum urinary flow rate on urodynamic examination. If regular anti-inflammatory treatment is not effective and tuberculosis infection can be excluded, the presence of this “special” inflammatory disease is highly suspected. If the doctor suspects this disease, he or she will recommend that the patient undergo a cystoscopy. The general or common cystoscopic presentation of cystitis (non-specific infection) is “increased and thickened mucosal vascular texture”, whereas adenocystitis has a more specific cystoscopic presentation: (1) cystic changes: vesicles of varying size in the triangle or around the urethral orifice, occasionally in the lateral and parietal walls, either singly or in clusters. In the early stage, they are translucent and contain clear fluid; in the late stage, the cysts harden and become yellowish gray, and the cysts are filled with yellow mucus or colloidal material. (2) Choroidal hyperplasia (or blanket-like changes): lesions resembling choroidal fabric that fuse together or are divided by normal or mildly abnormal bladder mucosa into small patch-like lesions. (3) Papillomatous type: bladder triangle or neck; multicentric, either scattered, patchy, or clustered papillary lesions that may be combined with lobulated and follicular lesions. The ureteral orifice is mostly indistinct. (4) Chronic inflammatory type: increased and thickened mucosal vascular texture prevailing in the bladder; (5) No significant mucosal changes type: no typical inflammatory manifestations, only localized mucosal vascular congestion or hemorrhage. The fundamental reason for the different cystoscopic manifestations of adenocystitis as opposed to common cystitis is the difference in the pathology of the two! There are four pathological histological types of adenoid cystitis: 1 migratory epithelial type: characterized by brunn’s nests; 2 intestinal epithelial type: fissures appear in brunn’s nests, forming branching or annular lumen, with glandular tissue in the center, transforming into glandular structures; there is also infiltration of lymphocytes and plasma cells; at this time the nucleus is located on the basal side and the top of the cytoplasm contains abundant mucus vacuoles; 3 prostatic epithelial type: glandular The epithelium is unilamellar columnar, cuboidal or pseudostratified columnar. The glandular lumen is large, with more zou and varying heights. The glandular epithelium has irregular microvilli and abundant intracellular rough endoplasmic reticulum and secretory granules; collagen-like basement membrane between glandular epithelium and stroma; 4 Mixed migratory-prostatic epithelium type. Microscopically, both brunn’s nest and prostate tissue transformation structures are present. It is the similar structure of “glandular tissue” that makes this type of cystitis called “glandular cystitis”! Adenocystitis with widely diffused nests and cysts is considered to be a precursor to precancerous lesions. Doctors are extra vigilant and pay attention to adenocystitis because of the possibility of precancerous changes. How to treat adenocystitis if you have it? How to prevent the “progressive development of cancer”? In my own experience, removal of the diseased mucosa is the most ideal treatment. The advances in medicine nowadays have made it possible to treat most diseases without the need for “radical” surgery or experimental treatment with drugs of uncertain efficacy. Electrodesiccation or laser cautery of the diseased mucosa through the urethra is a minimally invasive treatment that is very effective. Postoperative treatment with intravesical drug infusion can be appropriate. This treatment is much more effective than bladder irrigation alone. Different inflammatory conditions are treated differently to have a good outcome. It’s actually quite philosophical to see a doctor! P.S. Choice of drugs for perfusion: mainly anti-cancer drugs or immune enhancers such as BCG, mitomycin, 5-FU, chymotrypsin, cetiapide, etc.