Andrology: diseases — симптомы, диагностика и лечение

A prostate cyst is a fluid-filled cavity in or near the prostate tissue. Most often it is found by chance during ultrasound or TRUS, and it does not manifest itself in any way. Cysts can be congenital, when remnants of the embryonic ducts remain, and acquired, due to blockage of the excretory ducts of the gland due to prostatitis or adenoma. Most of these formations are benign, do not grow and do not require treatment: observation is sufficient. Large cysts that make it difficult to urinate, cause pain, fester or affect fertility require attention - in these cases, the urologist suggests active tactics.

Leukocytospermia is an increased number of leukocytes in semen, which is detected during a spermogram. All men have a small number of leukocytes in the ejaculate, but exceeding the accepted threshold indicates inflammation in the male reproductive system: most often in the prostate gland, seminal vesicles, epididymis or urethra. This in itself is not a diagnosis, but a signal to look for the cause. Leukocytes release reactive oxygen species that damage the membrane and DNA of sperm, so the condition is important for couples planning pregnancy and requires examination by a urologist or andrologist.

A spermatic cord lipoma is a benign tumor of adipose tissue that grows as part of the structures that run from the inguinal canal to the testicle. This is the most common formation in this area: it is soft, mobile, grows slowly and usually does not hurt. Often, a lipoma is discovered accidentally - during an ultrasound or directly during surgery for an inguinal hernia, since these two conditions often coexist. The doctor’s main task is to distinguish a lipoma from a hernia, spermatic cord cyst, and rare malignant tumor of adipose tissue. Therefore, the removed node is always sent for histological examination, and an ultrasound is performed before the operation.

Testicular microlithiasis is multiple tiny deposits of calcium in the seminiferous tubules. On an ultrasound of the scrotum, they look like scattered bright dots without an acoustic shadow, which is why the picture is sometimes described with the figurative expression “starry sky.” Microlithiasis itself does not cause pain, does not interfere with erection, and is not a tumor or stones in the usual sense. Most often, this is an incidental finding during examination for another reason. What matters is not the fact of calcifications itself, but the accompanying circumstances: infertility, an undescended testicle in childhood, testicular atrophy, a previous tumor. They are the ones who determine whether observation is needed and to what extent.

Thrush in men is candidal balanitis or balanoposthitis, an inflammation of the glans penis and foreskin caused by yeast-like fungi of the genus Candida. These fungi live in small quantities on the skin and mucous membranes, and the disease occurs when the balance is disturbed: with diabetes, after a course of antibiotics, against the background of decreased immunity, narrow foreskin and insufficient hygiene. Typical complaints are itching, burning, redness and a white cheesy coating with a sour odor, pain during urination and sexual intercourse. The condition is highly treatable, but persistence or recurrence almost always means there is an underlying cause that needs to be found.

Prostatitis is inflammation of the prostate gland. This is one of the most common urological problems in young and middle-aged men and at the same time one of the most “treatable” diagnoses: the word prostatitis hides completely different conditions - from acute bacterial inflammation, requiring immediate antibiotic therapy, to chronic pelvic pain syndrome, where antibiotics are not needed at all. Therefore, treatment begins not with pills, but with accurate diagnosis.

Kallmann syndrome is a congenital condition in which puberty does not begin or stops, and the sense of smell is severely reduced or absent. The reason is that in the prenatal period, the nerve cells that produce gonadotropin-releasing hormone do not reach the right place in the brain: they migrate along with the olfactory nerves, and disruption of this pathway affects both hormonal regulation and the sense of smell. As a result, the pituitary gland does not receive a signal, sex hormones are not produced, and the teenager does not enter puberty. The condition responds well to treatment: replacement therapy ensures the development of secondary sexual characteristics, and special regimens allow many patients to have their own children.

A weak stream of urine is a feeling that the pressure has become sluggish, you have to wait for the start of urination, and in the end the urine is released drop by drop. The symptom is considered a sign of impaired bladder emptying: either there is an obstruction in the outflow path, or the bladder muscle does not contract strongly enough. In men over 50 years of age, the main cause is benign prostatic hyperplasia, followed by narrowing of the urethra and prostatitis. In women, prolapse of the vaginal walls, consequences of operations and neurological disorders are more often to blame. The symptom develops slowly, one gets used to it, but over time it leads to residual urine, infections, stones and acute urinary retention, so you should not postpone a visit to the urologist.

Funiculitis is an inflammation of the spermatic cord, a cord that runs from the testicle to the inguinal canal and contains the vas deferens, vessels and nerves. Most often, it does not become inflamed on its own, but together with the epididymis, when the infection rises from the urethra or prostate gland. A man notices a painful thickening above the testicle, the pain radiates to the groin and lower abdomen, and the temperature may rise. A separate task of the doctor is to exclude testicular torsion, in which the clock counts. Acute funiculitis responds well to treatment with antibiotics and rest, but prolongation increases the risk of chronic pain and problems with duct patency.

Cystitis in men is inflammation of the bladder mucosa. It occurs much less frequently than in women because the male urethra is longer and curved, and prostate secretions have antibacterial properties. That is why male cystitis is almost always secondary: it is caused by an obstruction to the outflow of urine, inflammation of the prostate, stone, narrowing of the urethra or diabetes mellitus. It manifests itself as pain when urinating, frequent urges and pain above the pubis. It is pointless to treat only the symptoms: without finding and eliminating the cause, the inflammation returns, so examination by a urologist is mandatory.