Öz
Pelvic floor problems are due to using the same sensory-motor nerve system by different organ groups, which located near each other. 66 years old male patient, who is using alfa bloker treatment for 10 years. For last 2 years, despite to have used alpha blocker treatment, increasingly pollakiuria, dysuria, stranguria, dripping at the end of urine, pain from the anus to the penis, recurrent tenesmus and constipation had been described. Physical examination of the patient showed positive tenderness at the rectal region and anal fissure at 12 o'clock. In addition to registering to continue the current treatment of alpha blockers; Rectal suppositories (0.92 mg Fluocortolone pivalate and 0.95 mg Fluocortolone caproate) / day. Oral tablet (172 mg Pancreatin) 3 times / day. Anal pomade (Lidocaine 5% Pomade Blood) 3 times / day. Anal epithelium pomade (Centella asiatica extract) 3 times / day. 7th day of treatment he came for control. Penis and in the anal area pain, tenesmus, and dripping at the end of urine had completely healed. Uroflowmetric and voiding pattern had improved. Resolving the primary problems in the anal region may also remove the urogenital system complaints.
Anahtar Kelimeler
Anal Fissure Benign Prostatic Hyperplasia Penile Pain Dysuria
Kaynakça
- Adil E. Bharucha, Tae Hee Lee, MD. Anorectal and Pelvic Pain. Mayocp. October 2016Volume 91, Issue 10, Pages 1471–1486
- Moghaddasi, M., Aghaii, M., and Mamarabadi, M. Perianal pain as a presentation of lumbosacral neurofibroma: a case report. J Neurol Surg Rep. 2014; 75: e191–e193 )
- Clemens, J.Q. Male and female pelvic pain disorders—is it all in their heads? ([editorial])J Urol. 2008; 179: 813–814
- Potts, J.M. and Payne, C.K. Urologic chronic pelvic pain. Pain. 2012; 153: 755–758
- Nickel, J.C., Downey, J., Hunter, D., and Clark, J. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol. 2001; 165: 842–845
- Collins, M.M., Stafford, R.S., O'Leary, M.P., Barry, M., and How common is prostatitis? A national survey of physician visits. J Urol. 1998; 159: 1224–1228
- Anothaisintawee, T., Attia, J., Nickel, J.C. et al. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis. JAMA. 2011; 305: 78–86
- Rees, J., Abrahams, M., Doble, A., Cooper, A., and Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015; 116: 509–525
- de Groat WC1. Integrative control of the lower urinary tract: preclinical perspective. Br J Pharmacol. 2006 Feb;147 Suppl 2:S25-40.
Öz
Pelvik taban sorunları komşuluk ve sinir duyu sistemleri
ortaklığı nedeniyle bir bütündür. 66 yaşında erkek hasta, 10 yıldan bu yana
prostat medikal tedavisi alıyor. Alfa
bloker tedaviye rağmen düzelmeyen artıp azalmalarla devam eden ve 2 yıldan bu
yana belirginleşen ; idrar yanması, sık idrara çıkma, bekleyerek ve zorlanarak
idrar yapma, idrar bitiminde uzun süren damlama, anal bölgeden penis boyunca
uzanan ağrılar, tekrarlayan konstupasyon ve tenezm atakları ile başvurdu. Hastanın Fizik muayenesinde pozitif bulgu
olarak rektal bölgede hassasiyet ve saat 12 hizasında anal fissür mevcuttu. Hastamız
alfa bloker mevcut tedavisine devam etmek kaydı ile ek olarak; Rektal supozituar ( 0.92 mg Fluokortolon
pivalat ve 0.95 mg Fluokortolon kaproat ) / gün. Oral tablet (172 mg Pankreatin)3 kez/gün. Anal
pomad (Lidokain % 5. Pomad Bazı) 3 kez/gün.
Anal epitelizan pomad (Centella asiatica ekstresi.) 3 kez/gün. Penis ve
anal bölgedeki ağrı, tenezm, ve idrar bitiminde damlama tamamen düzelmiş. Üroflowmetrik veriler ve voiding paternı düzelmişti. Anal bölgedeki birincil sorunların
çözülmesi ürogenital sistem yakınmalarını da ortadan kaldırabilmektedir.
Anahtar Kelimeler
Kaynakça
- Adil E. Bharucha, Tae Hee Lee, MD. Anorectal and Pelvic Pain. Mayocp. October 2016Volume 91, Issue 10, Pages 1471–1486
- Moghaddasi, M., Aghaii, M., and Mamarabadi, M. Perianal pain as a presentation of lumbosacral neurofibroma: a case report. J Neurol Surg Rep. 2014; 75: e191–e193 )
- Clemens, J.Q. Male and female pelvic pain disorders—is it all in their heads? ([editorial])J Urol. 2008; 179: 813–814
- Potts, J.M. and Payne, C.K. Urologic chronic pelvic pain. Pain. 2012; 153: 755–758
- Nickel, J.C., Downey, J., Hunter, D., and Clark, J. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol. 2001; 165: 842–845
- Collins, M.M., Stafford, R.S., O'Leary, M.P., Barry, M., and How common is prostatitis? A national survey of physician visits. J Urol. 1998; 159: 1224–1228
- Anothaisintawee, T., Attia, J., Nickel, J.C. et al. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis. JAMA. 2011; 305: 78–86
- Rees, J., Abrahams, M., Doble, A., Cooper, A., and Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015; 116: 509–525
- de Groat WC1. Integrative control of the lower urinary tract: preclinical perspective. Br J Pharmacol. 2006 Feb;147 Suppl 2:S25-40.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Olgu sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Aralık 2018 |
| Gönderilme Tarihi | 4 Mayıs 2018 |
| Kabul Tarihi | 25 Mayıs 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 6 Sayı: 2 |
