Interview with Doctor of Medical Sciences, Professor Mirzagalib Tillashaykhov:
- What innovations have been introduced in the surgical treatment of prostatitis, which is more common in men?
- According to statistics, chronic prostatitis occurs in 25-25% of men after the age of 80, and recently there has been an increase in the incidence of the disease. It should be noted that the main causes of prostatitis are sex, sedentary lifestyle, alcohol, tobacco consumption, medication without a doctor's permission. Chronic prostatitis usually develops slowly without clinical signs, and the prostate gland becomes inflamed due to stagnation of blood circulation in the small pelvis. First, the blood vessels of the prostate gland dilate, and then there are scar-sclerotic changes, which lead to impaired urination, decreased sexual ability, fatigue, and nervousness.
Prostatitis is divided into infectious and non-infectious types. In infectious prostatitis, the prostate gland is damaged by germs, viruses, bacteria. Non-infectious prostatitis occurs without pathogens. The onset of the disease is caused by blood clots in the prostate gland, inactivity, chills. The following factors also cause prostatitis:
Peculiarities of the anatomical structure of the prostate gland, hormonal disorders, age-related changes, as well as inflammatory diseases of the urinary tract and kidneys and bladder (such as urethritis), constipation, urinary incontinence, sedentary work, often driving These include prolonged stay, chronic lumbar radiculitis, and weakened immune systems.
Treatment for prostatitis includes antibacterial therapy, prostate massage, physiotherapy, strengthening the immune system, and lifestyle changes. The expected results can be achieved only when these treatments are used together.
- Is surgery positive in calculous prostatitis (small stones in the prostate)? Does the patient not have subsequent complications?
- Calculus prostatitis is a type of chronic prostatitis caused by long-term inflammation of the prostate gland and is detected by ultrasound on 8,4% of men of different ages. The incidence of calculous prostatitis in men aged 30-39 years is mainly due to various infectious and inflammatory diseases of the prostate gland (chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, mycoplasmosis, etc.). Among men aged 40-59 years, calculous prostatitis is caused by prostate adenoma.
Calculus prostatitis is mainly treated conservatively. This treatment includes antibacterial, nonsteroidal, phytotherapy, physiotherapy (magnetic therapy, ultrasound therapy, electrophoresis). Recently, low-intensity lasers have been used for non-invasive crushing of prostate stones. Prostate massage is strictly prohibited in patients with calculous prostatitis.
Surgical treatment of stone prostatitis is usually performed in complicated cases and in cases of prostate adenoma. If an abscess develops as a result of the disease, surgery is performed and the stones are removed along with the pus. Sometimes moving exogenous stones are lowered into the bladder using special instruments and lithotripsy is performed. Large stones are removed from the intermediate area and with lateral incisions. In case of co-occurrence of prostate adenoma, adenomectomy, prostate TUR operation, prostatectomy surgery are performed.
- At what stages of prostate adenoma can a patient be treated without surgery?
- The clinical picture of prostate adenoma consists of 3 stages. In the first stage, the patient has frequent urination and false alarms. This stage is the primary signal for patients to seek medical attention. In the second stage, the patient has difficulty urinating completely, and there is residual urine in the bladder, resulting in infectious inflammation of the mucous membranes. In the third stage, the amount of residual urine after urination increases to 1,5-2,0 liters.
Treatment for prostate adenoma is divided into pharmacological and surgical. In the first and second stages, prostate adenoma is treated conservatively. Unfortunately, conservative therapy does not help in the treatment of the third stage and surgery is performed.
- Does surgical treatment of urethral tumors adversely affect urethral function?
- We know that after any surgical procedure, various large and small complications can be observed. In patients with urinary tract polyps and small benign tumors, urethral function is completely restored after surgery, and partial dysfunction due to scarring is observed.
- Is surgery useful in azoospermia?
- Azoospermia is a disease characterized by the complete absence or very small number of sperm in the seminal fluid and is one of the most severe forms of male infertility.
There are two types of azoospermia.
Obstructive azoospermia is caused by a violation of the permeability of the seminal vesicles.
Secretory azoospermia is a disorder of sperm production in the testicles for a number of reasons. Treatment of azoospermia is primarily concerned with eliminating the cause of the disease.
Conservative (drug treatment) and special anti-inflammatory treatments, as well as hormonal therapy to correct hormonal imbalances are prescribed.
Surgical treatment is performed on the patient to restore the permeability of the fallopian tubes.
Currently, there are the following types of sperm separation:
TEZE - separation of sperm from testicular tissue;
MEZA - Aspiration of sperm from the seminal vesicles by biopsy;
PEZA is the aspiration of sperm through the skin through the seminal vesicles.
Infertility is eliminated in patients after surgery to restore the permeability of the fallopian tubes. If this does not work, artificial insemination is used.
- At what stage of varicocele (dilation of the venous blood vessels of the seminal vesicles) surgery is indicated?
- There are 4 stages of varicocele disease. The first stage - varicose veins are detected by UTT or dopplerography examinations. The second stage is when the dilated veins are palpated while the patient is standing. The third stage - dilated veins are felt on palpation (finger palpation), regardless of the patient's condition. The fourth stage is the visualization of dilated veins and seminal vesicles.
If the patient has pain or infertility in the area of the pelvis, surgery should be performed as soon as possible, regardless of the stage of the disease. If varicocele does not bother the patient, it can be treated without surgery if there is no need to procreate. There are 3 main types of varicocele treatment.
Conventional surgery (Ivanissevich operation).
Endoscopic surgery.
Sclerosis of the varicose veins.
"When a hernia is removed, won't it reappear later?"
- Choveal hernias are treated conservatively and operatively in men and boys. The conservative method, which involves wearing a special bandage, is more common in the operative-radical method, which is more common in hernias.
One of the complications is the recurrence of hernia after surgery. However, depending on the patient's postoperative lifestyle, the risk of such complications will automatically decrease if the patient adheres to the doctor's instructions after the operation. Patients should limit physical and physical exertion, wear a special bandage for a specified period of time after surgery, and prevent constipation.
- How are the surgical procedures for the treatment of genital tumors in men today different from previous years?
“Today, not only in Uzbekistan, but in all countries of the world, medicine is rapidly improving and improving year by year, and today there are new modern diagnostic tools and special surgical equipment that meets world standards and meets new requirements. Even many surgeries performed by our qualified specialists are not inferior to the complex surgeries performed in developed countries. Early detection of cancer has made it possible to treat it quickly and without complications. We should be happy about that, of course.
