Thimble bladder is seen in -

Ans. is 'a' i.e., Tuberculosis o Bladder tuberculosis is almost always secondaryto renal tuberculosiso The disease starts at the ureteric opening, the earliest evidence being pallor of the mucosa due to submucosal edema.o Subsequently tiny white transluscent tubercles develop all over. Gradually these tubercles enlarge and may ulcerate (but do not cause bladder perforation).o These tubercles lend 'cobblestone* appearance on cystoscopy.o There is considerable submucous fibrosis which causes diminished capacity of bladder. Scarred & fibrosed, small capacity bladder is b'a thimble bladder.o The fibrosis which usually starts around the ureter, contracts to cause a pull at the ureters. This either leads to a stricture or displaced, dilated and rigid wide mouthed ureter k/a golf hole ureters, this almost always leads to ureteral reflux.