Andrology: diseases — симптомы, диагностика и лечение

Erectile dysfunction is the persistent inability to achieve or maintain an erection sufficient for sexual intercourse. It is customary to talk about it when the problem persists for at least three months: isolated failures happen to any man and are not considered a disease. It is important to understand the main thing: ED today is considered not only as a sexual problem, but also as an early signal about the condition of blood vessels, often ahead of the appearance of cardiac symptoms by several years.

Prostate adenoma, or benign prostatic hyperplasia (BPH), is a growth of prostate tissue that compresses the urethra and interferes with the normal flow of urine. This is not cancer or a precancerous condition, but it is BPH that most often spoils the quality of life of men after fifty: frequent rises at night, a weak stream, a feeling of incomplete emptying. Without treatment, the disease can lead to complete urinary retention and kidney damage.

Infertility in a couple is said to occur when pregnancy does not occur within a year of regular sexual activity without contraception. In approximately half of such cases, a male factor is detected, either as the sole cause or in combination with a female factor. At the same time, examining a man is simpler, faster and cheaper than a woman’s, so it makes sense to start with him - with a spermogram.

Prostate abscess is a limited accumulation of pus in its tissue, a severe complication of acute bacterial prostatitis. Microbes, often E. coli and other gram-negative bacteria, cause inflammation, and then the area of ​​the gland melts to form a cavity. The condition is manifested by high fever with chills, severe pain in the perineum and rectum, painful and difficult urination, up to complete urinary retention. This is an emergency situation: without timely drainage, the abscess can burst and lead to sepsis. The diagnosis is confirmed by transrectal ultrasound or computed tomography, treatment is carried out in a hospital.

Monorchism is a condition in which a man has only one testicle, anorchism is when the testicles are completely absent. The cause may be a violation of the laying of the organ in the prenatal period or its death due to vascular torsion even before birth. It is important to distinguish these conditions from cryptorchidism, in which the testicle exists, but has not descended into the scrotum and is located in the groin or abdominal cavity - such a testicle must be found and brought down. With monorchidism, a single healthy testicle usually fully provides both hormones and sperm production. Anorchism requires lifelong replacement therapy, which is selected by an endocrinologist and urologist.

Varicocele is an enlargement of the veins of the spermatic cord, essentially varicose veins of the testicle. It occurs very often, in the vast majority of cases on the left, and often does not bother you at all. The main question with this diagnosis is not “is there a varicocele”, but “does it affect the testicle and fertility” - it is the answer that determines whether surgery is needed or observation is sufficient.

Vesiculitis is an inflammation of the seminal vesicles, the paired glands located behind the bladder that produce most of the liquid portion of semen. It is rare in isolation: usually the infection comes from neighboring organs, most often from the prostate gland in prostatitis, less often from the urethra or through the bloodstream in general infections. Characteristic signs are pain in the depths of the pelvis and perineum, intensifying with ejaculation, and blood in the semen. Vesiculitis responds well to treatment, but requires precise selection of antibiotics and a fairly long course, otherwise it becomes chronic.

Delayed sexual development is said to occur when a girl’s breasts have not begun to grow by the age of 13, or when there is no menstruation by the age of 15, and a boy’s testicles do not enlarge by the age of 14. A teenager lags behind his peers in height and physique, which is often more severe than the medical problem itself. Most often, the reason is harmless: it is a constitutional delay, a family trait in which maturation simply begins later, and the final growth is normal. But sometimes the delay is due to chronic diseases, nutritional deficiencies, excessive physical activity, diseases of the thyroid gland, pituitary gland or gonads. A simple examination by an endocrinologist will help you figure it out.

Cavernitis is an inflammation of the cavernous (cavernous) bodies of the penis, that is, those structures that fill with blood during an erection. The disease occurs infrequently, but is severe: pain, swelling and redness of the penis, a dense painful area inside the tissue appear, and the temperature rises. The infection gets there from the urethra with purulent urethritis, through the blood with another purulent focus, as well as with trauma, injections into the cavernous bodies or prolonged priapism. The danger of cavernitis lies in its consequences: a scar can form at the site of inflammation, which leads to curvature of the penis and persistent erectile dysfunction. Therefore, treatment begins urgently and usually in a hospital.

Prostate stones, or calcifications, are deposits of calcium salts in the ducts and tissue of the prostate. They are often discovered incidentally during ultrasound in middle-aged and older men. Small calcifications themselves usually do not cause complaints and do not require treatment: this is a consequence of age-related changes, stagnation of secretions or previous inflammation. They become important if they are combined with chronic prostatitis, prostate adenoma, pain in the perineum or urination problems, since bacteria can persist in the stones. Calcifications do not turn into cancer, but when they are detected, the urologist evaluates the condition of the prostate as a whole. They treat not the findings on ultrasound, but the symptoms and concomitant diseases.