THIMBLE OR SYSTOLIC BLADDER

It is inability of the bladder to relax and distend and so inability to retain the urine as required. extreme fibrosis and contracture of the bladder walls, resulting in a tiny bladder.

most commonly seen as a result of genitourinary tuberculosis. Bladder involvement in urinary TB is usually a “downstream” result of renal infection and is present in one third of patients with renal TB.

CAUSES

• Tuberculous cystitis
• Schistosoma haematobium
• Interstitial cystitis
• Radiotherapy
• Malignancy
• Previous bladder surgery.

CLINICAL FEATURES

• Bladder is fibrotic and contracted, with difficulty in dilating and accommodating urine as needed.
• Bladder capacity is less than 100 ml (60 ml).
• decreased bladder capacity
• Frequency of urine
• Features of recurrent cystitis.

INVESTIGATIONS

• Cystoscopy.
• Cystography.
• IVU.
• Urine C/S.

TREATMENT

Hydrostatic dilatation.

Augmentation of bladder by doing ileocystoplasty or caecocystoplasty or sigmoidocystoplasty.

HOMOEOPATHIC MANAGEMENT:

• NITRIC ACID
• SARSAPIRILLA
• STAPHYSAGRIA
• THUJA
• CAUSTICUM