Urology: diseases — симптомы, диагностика и лечение

Pyeelectasia is an enlargement of the renal pelvis, which is most often discovered accidentally on ultrasound in a fetus or in an infant. This in itself is not a diagnosis or a disease, but a finding that indicates that the flow of urine from the kidney may be obstructed. In most children, mild pyeelectasis disappears on its own during the first or second year of life as the urinary tract grows. However, in some children there is an obstruction to the outflow or backflow of urine from the bladder, and then further examination and observation by a urologist is needed to preserve kidney function.

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.

Urethral cancer is a rare malignant tumor of the urethra that grows from the cells of its mucous membrane. It develops more often against the background of long-term chronic inflammation, cicatricial narrowing of the urethra, or a previous human papillomavirus infection. The tumor masquerades as usual urological complaints for a long time: the stream of urine weakens, an admixture of blood appears, a burning sensation, and in women - discharge and a dense nodule under the mucous membrane. Because of this, the diagnosis is often made late, when the tumor has already spread to neighboring tissues and inguinal lymph nodes. The conclusion is simple: persistent urination problems, blood in the urine or a palpable lump in the urethra require examination by a urologist and examination of the canal from the inside, rather than waiting.

Reactive arthritis is an inflammation of the joints that occurs several weeks after an intestinal or urogenital infection. There is no pathogen in the joint itself: the immune system, having responded to the microbe, continues to attack its own tissues due to the similarity of their structures. Typically, a few joints of the legs are affected - the knee, ankle, and toe joints, often asymmetrically. The triad with inflammation of the joints, eyes and urethra is considered classic, but not everyone has it completely. Most patients recover within a few months, but in some the disease takes a protracted course, so observation by a rheumatologist is necessary.

Sclerosis of the bladder neck is a scar narrowing of the place where the bladder meets the urethra. The symptoms are almost indistinguishable from prostate adenoma: weak stream, straining, feeling of incomplete emptying. This is why this diagnosis is often made late, and the typical situation is a man whose urination initially improved after successful prostate surgery, but after a few months it worsened again.

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 during pregnancy is an inflammation of the bladder mucosa, most often caused by E. coli. Pregnancy creates favorable conditions for it: hormones relax the urinary tract, the growing uterus puts pressure on the bladder and prevents its complete emptying, and urine stagnates. Hence the frequent painful urge, pain at the end of urination and cloudy urine. The main danger is not in the symptoms themselves, but in the fact that the infection easily rises to the kidneys and turns into pyelonephritis, which increases the risk of premature birth. Therefore, cystitis in pregnant women is always treated, and treated according to the result of urine culture.

Cystitis in children is an inflammation of the bladder mucosa, one of the most common urinary tract infections in childhood. Girls are more often affected due to the short urethra and the proximity of the external opening to the anus. Typical signs are frequent painful urination in small portions, pain in the lower abdomen, and sometimes daytime incontinence in a child who has already been potty trained. The key task of the doctor is to distinguish cystitis from pyelonephritis, in which the infection affects the kidney and a high temperature appears. Diagnosis is made by a properly collected urine test and confirmed by culture.

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.