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Colliculitis is an inflammatory lesion of the seminal hillock (otherwise tubercle, follicle), the so-called colliculus, located in the posterior region of the urethra near the prostate gland and having an approximate size of 20mm x 5mm x 5mm. In the area of the collicle there are receptors that are responsible for the formation of the sensation of orgasm, the cavity (male uterus), as well as the openings of the vas deferens.
In world medical practice, the diagnosis of “colliculitis” does not appear (probably due to the fact that isolated inflammation of the seminal tubercle is an extremely rare occurrence), but is widely used in the post-Soviet space.
Types and causes of colliculitis
Colliculitis in most cases has an infectious origin and develops against the background of an already existing lesion of the urogenital tract (for example, with prostatitis – an inflammatory pathology of the prostate gland, urethritis – inflammation of the mucous membrane of the urethra, etc.), this option is called “secondary colliculitis”. If the causative agent of the infection can be differentiated, then this is indicated when making a diagnosis. So, chlamydial colliculitis often accompanies the course of chlamydial urethritis, when both the anterior and posterior regions of the urethra are affected. Also, colliculitis can develop after epididymitis (inflammation of the epididymis), vesiculitis (inflammation of seminal vesicles) and other diseases of the genitourinary system. Sometimes the infection is introduced into the colliculus from relatively distant organs (kidneys, tonsils, gallbladder, joints, caries-affected teeth, etc.) with a flow of lymph or blood. Treatment of colliculitis is carried out with specific drugs in accordance with the nature of the pathogen.
In some cases, the disease may be non-infectious in nature. The so-called interstitial colliculitis (hypertrophic, surrounding).
In addition to interstitial colliculitis, Vasiliev A.I. (1913) identified the following types of disease:
- catarrhal superficial chronic colliculitis;
- granulomatous;
- ulcerative granulomatous superficial;
- atrophic;
- pachydermatic;
- desquamative;
- mixed.
Primary colliculitis can occur with a direct lesion of the seminal tubercle as a result of infection during sexual contact (the pathogen enters through the urethra). However, in such a situation, inflammation, as a rule, simultaneously captures other nearby tissues and organs.
True colliculitis can be the result of circulatory disorders in collicular tissues due to congestion in the pelvic veins, in the prostate (for example, with an inactive lifestyle, prolonged sexual intercourse, chronic constipation, prolonged sexual abstinence, frequent practice of interrupting sexual intercourse, etc.).
According to the type of development and extent of the inflammatory process, the disease is acute and chronic. In addition, there are forms of the disease:
- atrophic (with the formation of dense scars);
- with soft infiltration (the volume of connective tissue is small);
- with solid infiltration (with predominance of connective tissue elements).
Symptoms of colliculitis
There are no characteristic signs of inflammation of the collicle. Since the pathology proceeds with simultaneous damage to other organs and tissues, there are corresponding manifestations of prostatitis, urethritis or other diseases of the genitourinary system, such as:
- pain in the groin, radiating to the scrotum, inner thigh, lower abdomen; discomfort in the rectum, groin, a feeling of fullness, the presence of a foreign object;
- tingling, pain, burning during ejaculation (due to spasm of the posterior urethral region, leading to infringement of the inflamed collicle);
- urination due to blockage of the lumen of the urethra with swollen tissues (weak, intermittent stream, soreness);
- the appearance of traces of blood in the urine / semen;
- spontaneous ejaculation during defecation with hard stools, constipation;
- uncontrolled, inadequate, painful erection with violations of the latter, up to complete absence, during sexual contact;
- orgasmic obliteration, etc.
Methods for diagnosing and detecting a disease
First of all, if any unpleasant symptoms from the genitourinary system appear, it is necessary to consult a specialist – a urologist, venereologist, etc. The doctor will conduct a clinical examination, ask the patient about existing complaints, the duration and intensity of manifestations, the presence of concomitant and chronic pathologies, etc. d.
Laboratory research methods involve:
- blood tests (general, biochemical);
- urinalysis (general, with a cultural study, “three-glass sample”, etc.);
- urethral smear for microscopic examination, sowing on nutrient media in order to identify the pathogen;
- PCR diagnostics;
- analysis of seminal fluid, prostate secretion.
The main method of instrumental diagnostics for suspected colliculitis (also used to differentiate various forms of pathology) is ureteroscopy – examination of the urethra through a ureteroscope, a device that allows you to visualize all parts of the urethra. As a rule, the endoscopic picture of the disease is characterized by changes in the colliculus zone with posterior urethritis, while the localization of inflammation only in the seminal tubercle is extremely rare. At the same time, the ureteroscopist reveals a significant increase in the size of the collicle, its swelling and hyperemia, looseness and a tendency to mucosal bleeding. Interstitial colliculitis is manifested by a denser, rough surface of the seminal tubercle, its paler color compared to the surrounding tissues. Sometimes a doctor can detect small bubble-like formations, polyposis growths on the surface of the collicle.
With ulcerative lesions, erosions, ulcers with a coating of fibrin are noted. In the atrophic form of the disease, the collicle is significantly reduced in size. If the pathologies associated with colliculitis are vesiculitis and / or prostatitis, then during the examination there is a noticeable purulent discharge from the ducts of the prostate, the vas deferens. The presence of cicatricial changes may indicate previous inaccurate ureteroscopies or inadequate therapy (cauterization).
Treatment of colliculitis
Treatment of colliculitis is determined by the nature of the underlying pathology. In the presence of a bacterial process in the urogenital tract, a course of antibacterial drugs is prescribed (broad-spectrum or depending on the type of pathogen). Additionally, painkillers are prescribed. In some cases, the doctor may recommend to the patient the instillation of the urethra (infusion of drugs into the urethra), microclysters, suppositories, taking hormonal and / or vitamin preparations, undergoing physiotherapeutic procedures at the stage of recovery (for example, magnesium sulfate iontophoresis, potassium iodide). During the course of therapy, it is recommended:
- abstinence from sexual intercourse;
- proper, balanced nutrition;
- minimization of stressful situations;
- exclusion of hypothermia of the legs and pelvic area;
- examination and, if necessary, treatment of the sexual partner.
The effectiveness of the treatment method widely used in the past by cauterization with a solution of silver nitrate is questioned by modern specialists. Such a procedure not only does not improve the patient’s condition, but, in some cases leading to tissue damage and scarring, exacerbates painful manifestations and reduces the effectiveness of the main therapy, and can also cause orgasm disorders, obstruction of the vas deferens (and hence infertility). Laser exposure to the collicle is also not recommended. It is worth noting here that modern medicine follows the path of generalization of practice, thereby simplifying its task. The approaches are such that if a method can potentially harm, then this method is excluded from practice, because the main postulate of medicine is Do no harm. With this method of exceptions, almost everything that could be useful was removed. And at the same time, instillations of a solution of silver nitrate often have a positive effect in treatment, and can have side effects only in some cases. All this once again indicates that treatment should be approached individually.
By agreement with the attending physician, in addition to the main treatment, it is possible to use traditional medicine. For example, in the case of an atrophic variant of the disease or colliculitis with solid infiltration, oil / fatty preparations based on vaseline oil, sea buckthorn, rosehip, fish oil, etc. are infused into the urethra. In the absence of the desired result from conservative therapy, surgical intervention is possible – excision of hypertrophied fragments of the collicle using an electric knife (transurethral electroresection).
In any case, the treatment of colliculitis in men should be carried out with regular monitoring by a qualified doctor, taking into account the individual characteristics of the patient’s body, therapy of comorbidities based on international medical standards.
Complications
In the absence of treatment or inadequate therapy, colliculitis and its accompanying pathological changes in the urogenital tract can cause:
- urination disorders;
- impotence;
- infertility.
You should not delay treatment. At the first appearance of the symptoms described above, it is necessary to immediately take action to identify the disease and begin treatment. As with any other disease, colliculitis is much easier to cure in the initial acute stage. Prolonged inflammation of the seminal tubercle can lead to a significant deterioration in its functioning even after the inflammation has been eliminated.
Prevention
Nothing outstanding in the prevention of colliculitis can not be identified. These are all the same measures that are characteristic of any disease of the male genitourinary system. The basic rule is protected sex using a condom. But it will not be superfluous to list them again. The main measures to prevent diseases of the genitourinary system, including colliculitis, are:
- timely detection and adequate treatment of recurrent / chronic diseases (prostatitis, urethritis, etc.);
- correction of chronic pathological conditions (diabetes mellitus, etc.);
- regular sex life;
- safe sex;
- compliance with the rules of a healthy lifestyle and personal hygiene;
- hardening;
- avoidance of hypothermia, overheating, stress, etc.