Colliculitis – the Symptoms, Causes, and Treatment

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Stoyanov
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Colliculitis – the Symptoms, Causes, and Treatment

#1 Post by Stoyanov » 07 May 2018, 23:22

Colliculitis is inflammatory lesion of the seminal hillock (otherwise the tubercle, follicle), the so-called colliculus located in the posterior region of the urethra near the prostate gland, with the approximate dimensions of 20mm x 5mm x 5mm. There are receptors that are responsible for the formation of orgastic sensations, a cavity (prostatic utricle), as well as holes of the deferent ducts in the area of the colliculus.

The term “colliculitis” does not appear in the world medical literature (probably due to the fact that isolated inflammation of the seminal hillock is an extremely rare phenomenon), but it is widely used in the former Soviet Union.

Types and Causes of Colliculitis

Generally, colliculitis is of infectious origin and develops already affected existing lesion of the urogenital tract (for example, in prostatitis, which is an inflammatory pathology of the prostate, urethritis - inflammation of the mucous membranes of the urethra, etc.), this case is called “secondary colliculitis”. If the causative agent of the infection can be differentiated, then the diagnosis shall specify the same. Thus, 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 entered the colliculus from relatively distant organs (kidneys, tonsils, gall bladder, joint, decayed teeth, etc.) with lymph or blood flow. Colliculitis is treated using specific drugs depending on the nature of the pathogen.

In some cases, the disease may be noninfectious. This is a so-called interstitial (hypertrophic, surrounding) colliculitis.

In addition to interstitial colliculitis, A.I. Vasiliev (1913) identified the following types of the disease.
• catarrhal superficial chronic colliculitis;
• granulomatous colliculitis;
• ulcerative-granulomatous superficial colliculitis;
• atrophic colliculitis;
• pahidermatic colliculitis;
• desquamative colliculitis;
• mixed colliculitis.

Primary colliculitis can occur due to the direct damage to the seminal hillock as a result of infection during sexual intercourse (the pathogen penetrating through the urethra). However, in such a case, inflammation simultaneously reaches other adjacent tissues and organs as well.

True colliculitis can result from impaired blood circulation in the collicular tissues due to congestive phenomena in the pelvic veins, prostate (for example, due to sedentary lifestyle, prolonged sexual intercourse, chronic constipation, prolonged sexual abstinence, frequent interruption of intercourse, etc.).

According to the type of progression and extent of the inflammatory process, the disease may be classified as either acute or chronic. In addition, the following forms of the disease are distinguished:
• atrophic (accompanied by the forming of dense scars);
• with soft infiltration (the volume of connective tissue is law);
• with solid infiltration (connective tissue elements predominate).

Symptoms of Colliculitis

There are no characteristic signs of inflammation of the colliculus. Since pathology simultaneously affects other organs and tissues, manifestations of prostatitis, urethritis or other diseases of the genitourinary system can be observed such as:
• pain in the groin, irradiating into the scrotum, inner thigh, lower abdominal areas, discomfort in the rectum, groin, feeling of bursting or presence of a foreign object;
• tingling, pain, burning with ejaculation (due to a spasm in the posterior urethral section, leading to incarceration of the inflamed colliculus);
• inappropriate urination due to the obstruction of the urethral lumen by swollen tissues (weak, intermittent urine stream, soreness);
• traces of blood in urine/semen;
• spontaneous ejaculation during defecation with hard stools and/or intestinal obstructions;
• uncontrolled, inadequate, painful erection with erectile dysfunction, up to complete dysfunction , during sexual intercourse;
• indistinct orgasm, etc.

Methods of Diagnostics and Identification

First of all, if any unpleasant symptoms appear in the genitourinary system, it is necessary to contact a professional urologist, venereologist, etc. The doctor will conduct a clinical examination and survey of the patient for complaints, duration and intensity of the manifestations, concomitant and chronic pathologies, etc.

In vitro techniques involve the following testing:
• blood tests (clinical, biochemical);
• urine analysis (clinical, culture-based, “three-glass sample, etc.);
• urethral smear for microscopic examination, inoculation of media in order to identify the pathogen;
• PCR diagnostics;
• analysis of seminal fluid and secretion of the prostate gland.

The main technique of instrumental diagnostics when colliculitis is suspected (also used to differentiate various pathologies) is urethroscopy, which means examination of the urethra using a urethroscope, i.e. a device that allows visualizing all sections in the urethra. As a rule, endoscopic view of the disease shows changes in the region of the colliculus in the posterior urethritis, while inflammation localized in the seminal tubercle only is uncommon. In this case, the urethroscopist can reveal a significant increase in the size, swelling, flushing, and looseness of the colliculus, as well as the tendency to bleeding of the mucous membrane. Interstitial colliculitis is characterized by a denser, more roughened surface, and by paler color of the seminal hillock a compared with the adjacent tissues. Sometimes a doctor can detect small vesicular and polypous masses on the surface of the colliculus.

For ulcerative lesions, erosions and small ulcers with fibrinous pellicle can be observed. If the disease is of atrophic nature, the colliculus is substantially reduced in size. If vesiculitis and/or prostatitis turn out to be the concomitant pathologies, then the examination will display purulent discharge from the prostate ducts and deferent canals. Cicatricial changes may speak for earlier inaccurate urethroscopy or inadequate therapy (cauterization).

Treatment of Colliculitis

Treatment of colliculitis will depend on the nature of the underlying pathology. If there is a bacterial process in the area of the urogenital tract, a course of antibacterial treatment (either broad-spectrum or depending on the pathogen) shall be prescribed. In addition, anesthetics can be recommended. In some cases, the doctor can recommend urethral instillations (infusion of medicinal products into the urethra), microclysters, suppositories, hormonal and/or vitamin preparations, and physiotherapeutic procedures at the stage of recovery (for example, magnesium sulfate and potassium iodide ionophoresis). During the therapeutic course, the following measures should be taken:
• abstaining from sexual intercourse;
• healthy, balanced diet;
• minimization of stressful situations;
• avoiding hypothermia of the legs and pelvic region;
• examination and, if necessary, treatment of a sexual partner.

Today, the effectiveness of the treatment widely used in the past, which involves silver nitrate cauterization is questioned by contemporary professionals. Such a procedure not only does not improve the patient's condition, but, in a number of cases aggravates the painful manifestations and reduces the effectiveness of the main therapy through damaging and scarring the tissues, thus leading to anorgasmia and obstruction of the vas deferens (and, therefore, to infertility). Exposure of the colliculus to laser is not recommended either. It should be noted that modern medicine follows the path of generalization, thereby simplifying the challenge it faces. According to the adopted approaches, a method that poses a potential hazard must be excluded from practice, since the main postulate of medicine is “Primum non nocere” (“First, do no harm”). Following this method of exclusion, almost everything that could be useful has been eliminated. However, silver nitrate instillations are more likely to have a positive effect in treatment, with occasional side effects only. All this indicates that the treatment should be approached on a case-by-case basis.

Upon consulting the attending physician, natural remedies may be used in addition to the basic treatment. For example, for an atrophic form of the disease, or for a solid-infiltration colliculitis, it is recommended to infuse oil/fat preparations based on petrolatum, sea buckthorn oil, rosehip oil, fish oil, and so on. If conservative therapy yields no desired results, surgical intervention is possible, which involves excision of hypertrophied colliculus fragments using an electric scalpel (transurethral electric resection).

In any case, the treatment of colliculitis in men should be carried out under regular monitoring by a qualified physician, with due regard of the patient’s individual anatomy characteristics, and therapy of concomitant pathologies on the basis of international medical standards.

Complications

Without treatment or with inadequate therapy, colliculitis and accompanying pathological changes in the urogenital tract can cause:
• urination disorders;
• impotence;
• infertility.

Do not delay with the treatment. At the first sings described above immediately take action to identify the disease and start treatment. As with any other disease, colliculitis is much easier to cure at the initial acute stage. Prolonged inflammation of the seminal tubercle can impair its functioning even after the inflammation is eliminated.

Preventive Treatment

There is nothing special in the prevention of colliculitis. The same measures should be taken as for any disease of the male genitourinary system. The main rule is safer sex using a condom. However, it would not be inappropriate to name them once again. The primary measures to prevent any diseases of the genitourinary system, including colliculitis, are as follows:
• timely identification and adequate treatment of recurrent/chronic diseases (prostatitis, urethritis, etc.);
• management of chronic pathological conditions (diabetes mellitus, etc.);
• regular sexual activity;
• safer sex;
• adherence to the rules of a healthy lifestyle and personal hygiene;
• cold water treatment;
• avoiding excessive heat loss, overheating, stress, etc.

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