Kavernit – the inflammatory process arising in kavernozny (cavernous) bodies of a penis. Kavernit is followed by emergence of painful consolidation of a penis, its puffiness, skin hyperaemia, a spontaneous erection, temperature increase of a body, an intoksikatsionny syndrome. Formation of abscess of a kavernozny body with the subsequent break of an abscess in an urethra is possible. Diagnostics of a kavernit includes performing ultrasonography of a penis, PTsR a research and bacteriological crops separated from an urethra, if necessary - an uretroskopiya. In treatment of a sharp kavernit antibiotic treatment, physical therapy is used. At suppuration opening of abscess is shown; at fibrous deformation of a penis – a falloprotezirovaniye.
Kavernit – an infectious and inflammatory disease of a penis, characterized by damage of cavernous (kavernozny) bodies. In urology and andrology kavernit meets considerably less than other inflammatory diseases of the men's sexual sphere (uretrit, prostatitis, orkhit, the epididymite, balanopostit, etc.). Nevertheless, kavernit is very dangerous pathology which consequences can affect quality of sex life and male fertility. Therefore each man has to be informed on the possible reasons, signs and complications of a kavernit.
The penis is formed by two kavernozny (cavernous) bodies and one spongy (spongiozny) body which from above are covered with easily movable skin. The right and left kavernozny body have the cylindrical form; their structure allocates a disteel part (a top, an apex), a middle part and a proximal part (leg). Parallel to the ventral surface of cavernous bodies the spongy body of a penis in the thickness of which there passes the urethra settles down. At a kavernita not only cavernous bodies, but also a spongy body of a penis can be involved in inflammatory process. The basic functional purpose of cavernous bodies is providing and maintenance of an erection. Therefore danger of a kavernit is that the disease can promote development of erectile dysfunction.
Reasons of a kavernit
Kavernit can be a consequence of a direct travmatization or spread of an infection on kavernozny bodies of a penis. In the first case development of a kavernit is preceded by injuries of a penis or the surgeries which are followed by injury of kavernozny bodies. Post-injection kavernit results from intrakavernozny introduction of medicines or other chemicals. Bilateral kavernit can be a complication of a long kateterization of a bladder a constant catheter of Foley.
Infectious kavernit in most cases serves as a complication of a sharp nonspecific or specific uretrit (usually gonorrheal etiology). At the same time activators can get into kavernozny bodies as in the hematogenic way, and at a mikrotravmatization of a mucous membrane of an urethra at dab fence. Limfogenny spread of an infection on kavernozny bodies is observed in the presence of the general pyoinflammatory diseases (an anthrax, quinsy, caries, sinusitis, osteomyelitis, sepsis, etc.). Serves as a special form of an inflammation of kavernozny bodies syphilitic kavernit.
Classification of a kavernit
Depending on the course of inflammatory process kavernit can be sharp and chronic (spongiozit). At the same time the acute inflammation of kavernozny bodies can carry limited or poured, one - or bilateral character.
Taking into account an origin allocate two forms of a kavernit - pereloyny and syphilitic. At a pereloyny kavernit inflammatory process from a mucous urethra extends to submucous fabric, and then to a spongy and cavernous body. As a consequence of these processes serves formation of painful small knots which under the influence of treatment can completely resolve or remain on the place, leading to a zapustevaniye of cavernous bodies and deformation of a penis. Also perhaps abstsedirovany knot with the subsequent break of pus in an urethra or outside.
Syphilitic kavernit is observed at patients in the tertiary period of syphilis. Inflammatory small knots (gumm) initially arise in cavernous bodies of a penis, hardly will respond to treatment, but usually do not disappear at all.
Symptoms of a kavernit
The clinic of a sharp kavernit has pronounced character; at the same time symptoms of an inflammation arise suddenly and develop immediately. Sharp kavernit usually demonstrates from febrilny fever (38-39 °C), a fever, weakness, a headache, inguinal lymphadenitis. There is sharp penis pain; the long, almost not falling down spontaneous erection causes difficulties of an urination, sometimes – a sharp delay of urine. At a unilateral inflammation of a kavernozny body the penis is bent towards defeat. Even at reduction of an erection puffiness and a thickening of a penis, integument hyperaemia remains. At a penis palpation, on the course of kavernozny bodies dense infiltrate to which touch causes sharp morbidity is probed.
As the following stage of development of a sharp kavernit serves formation of abscess which is most often opened in an urethra gleam. The break of an abscess is followed by improvement of the general health, reduction of pain and puffiness of a penis, allocation from an urethra of a large amount of fetid pus. Together with pus there is a rejection of nekrotizirovanny soyedinitelnotkanny partitions of cavernous bodies that is followed further by violation of a krovenapolneniye of cavities and leads to erectile dysfunction.
After opening of abscess there comes the sklerozirovaniye stage: on the place of the emptied abscess the cicatricial fabric causing a penis curvature at an erection (Peyroni's disease) is formed. It also significantly complicates sexual intercourse or makes its carrying out impossible. Chronic kavernit proceeds with the erased symptomatology – mild pains in a penis, painful erections, formation of the centers of consolidation in a penis of various form and extent, erectile dysfunction.
Diagnostics of a kavernit
At emergence of painful consolidation in a penis it is necessary to address the urologist or the andrologist immediately. After clarification of complaints and circumstances of a disease, survey and a palpation of genitalia the expert directs the patient to the additional researches necessary for the correct diagnosis.
The laboratory stage of diagnostics of a kavernit includes survey microscopy of dab, bacteriological crops of urine and separated urethras; PTsR and the REEF of scrapes from an urogenital path, crops on existence of gonorrhea, the RPR test and other analyses. The patient with a gonorrheal or syphilitic kavernit has to be consulted by the venereologist. Ultrasonography of a penis acts as the most important method of tool diagnostics of a kavernit. At a chronic kavernit carrying out an uretroskopiya, kavernozografiya can be shown.
Treatment of a kavernit
Patients with diagnosed kavernity have to be treated and be observed in the conditions of an urological hospital. In an initial (infiltrative) stage of a sharp kavernit the conservative therapy including antibacterial medicines (macroleads, aminoglycosides, penicillin, nitrofurans), immunostimulators, resolvents is appointed. Instillations of antiseptic solutions are carried out to an urethra, physiotherapeutic procedures (magnetotherapy, laser therapy, ultrasonic therapy, UVCh, an electrophoresis). At a chronic kavernit the anti-inflammatory, immunostimulating therapy and local physiotherapeutic treatment is appointed.
In a stage of an abstsedirovaniye carrying out surgical intervention - a deep longitudinal section of cavernous bodies and drainage of a purulent cavity is shown. In case of development of gangrene the emergency operation of amputation of a genital is shown. When forming fibrous deformation surgical correction of a curvature of a penis is carried out; at erectile dysfunction endoprosthesis replacement of a penis can be required (falloprotezirovaniye).
Forecast and prevention of a kavernit
The timely address to the urologist-andrologist and the adequate therapy undertaken at an initial stage allow to cure kavernit without the remote consequences. In case of the complicated current kavernit can lead to organic impotence and male infertility. Restoration of sexual function in this case will be possible only by means of falloprotezirovaniye methods.
Prevention of a kavernit consists in the prevention of injuries of penis, timely treatment of uretrit, and also inflammatory and infectious processes of other localization. An important role is played by prevention of STD, refusal of casual sexual communications, use of barrier contraception.