MENOPAUSE DISEASE AND BLADDER NECK SCLEROSIS

by Georges Debled MD.

G. Debled. The menopause disease. Approaches to aging control : 19:17-24,October 2015

The menopause disease .pdf Octobre 2015. SEMAL Madrid

Aging of sexual organs and its treatment

solution is here

SCLEROSIS AND INFLAMMATION OF BLADDER NECK

Incontinence, urgencies, chronic cystitis and devastating disorder of interstitial cystitis can be the consequences of a bladder neck sclerosis and inflammation (see drawings)

Numerous bladder neck scleroses in women are the consequences of androgens’ deficiencies (mainly dihydrotestosterone) before menopause (oral contraceptive) or after menopause (menopause disease: see above).

Those bladder neck consequences (Incontinence, urgencies, chronic cystitis and devastating disorder of interstitial cystitis) due to androgens’ deficiencies may improve with mesterolone. Results can be spectacular.

As urologist Georges Debled MD. has an experience about bladder neck sclerosis (and its endoscopic surgery) in woman since 40 years. The last 10 years he discovered the role of dihydrotestosterone on the woman’s bladder neck and the benefit effect of mesterolone on this pathology.

There exists no description of mesterolone effect on bladder neck in the world literature. Those findings are disclosed here for the first time.

URETHRA AND BLADDER NECK IN WOMAN

· The inner part is constituted by a fibromuscular tissue in continuity with the fibromuscular tissue of the bladder (bladder neck)

· The medium part is constituted by the sphincter

· The external part is a conduct

Fig 1.

The bladder neck is known in the medical literature, even in medical books of great value, as the inner sphincter. As a sphincter is a muscular structure contracted around a natural orifice (red arrows) the bladder neck is not a sphincter. Surrounding a natural orifice, it is not contracted and its contraction leads to the opening of its natural orifice on the contrary of a sphincter!

Fibrosis of the bladder neck can be congenital but a great number of cases are acquired during life. When opening (green arrows) the bladder neck doesn’t open well and its maximum diameter is often less than 1 centimeter.


Bladder neck sclerosis (in green) with narrowing of the urethra	Bladder neck sclerosis (in green) without narrowing of the urethra	Moderate bladder neck sclerosis (striated in green) without narrowing of the urethra

BLADDER NECK SCLEROSIS CONGESTION AND INFLAMATION IN WOMAN

Bladder neck sclerosis with congestion

Endoscopy of bladder neck sclerosis with congestion

Bladder neck sclerosis with inflammation and inflammatory polyps

Endoscopy of bladder neck sclerosis with inflammatory polyps

INCIDENCE OF ADROGENS’DEFICIENCY ON WOMAN’S BLADDER NECK

Venous dilatations make the bladder neck congestive with and abnormal sensitivity.

· Mesterolone only treatment has cured spectacularly a woman with proved androgens’ deficiency (The Georges Debled’s study) who’s bladder neck was congestive with abnormal sensitivity. Urologist of this woman had proposed an endoscopic surgery which was postponed thanks the mesterolone treatment . This woman is free of symptoms since 6 years of continuous treatment with mesterolone.

ANATOMOPATHOLOGY OF BLADDER NECK SCLEROSIS IN WOMAN

Important sclerosis of bladder neck in woman

Normal musculature (in red) of bladder neck.

Sclerosis of bladder neck

(in green).

MECHANICAL CONSEQUENCES OF A BLADDER NECK SCLEROSIS

Hypertrophy of bladder musculature

Hypertension in upper urinary tract

Weak bladder musculature

Bad function of kidneys (which are under pressure)

How to know if the is an hypertension in the upper urinary tract ?

EVOLUTION OF LOWER URINARY TRACT INFECTION

AFTER REMOVING OF BLADDER NECK SCLEROSIS IN WOMAN

Immediately after bladder neck resection of fibrous tissue inflammation tissue may remains in the bladder wall or in anterior urethra.

Immediately after bladder neck resection of fibrous tissue inflammation tissue may remains in anterior urethra.

After bladder neck resection of fibrous tissue inflammation disappears generally completely within 3 months

Before bladder neck resection of fibrous tissue when opening the bladder neck doesn’t open well and its maximum diameter is often less than 1 centimeter.

Bladder neck after resection of fibrous tissue : right

Bladder neck after resection of fibrous tissue : left

How to know if there is an hypertension in the upper urinary tract ?


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