The prostate gland, or prostate, is similar in shape and size to a large horse chestnut fruit. It is located between the floor of the pelvis (urogenital diaphragm) and the base of the bladder. At the back, the prostate gland is adjacent directly to the rectum, through which palpation is possible (digital-erectal examination of the prostate gland). The prostate includes 30-50 individual glands, the totality of which is surrounded by a dense white connective tissue capsule (capsula prostatica). The secretory ducts (ductuli prostatici) of these glands open into the urethra, which descends vertically through the prostate. The prostate stroma consists mainly of smooth muscle fibers.
The prostate secretes a watery, slightly acidic fluid with a milky tint and the smell of horse chestnut. The secretion contains numerous enzymes (in particular, acid phosphatase), immunoglobulins, prostaglandins, which stimulate the activity of the uterus. The protein spermine promotes sperm motility and fertility. When sperm dries, the protein forms crystals, the presence of which in the vagina can be used in forensic examinations as evidence of rape.
Prostate tissue can be divided into three zones with ill-defined boundaries: the outer zone, the inner zone, and the periurethral zone in direct contact with the urethra. The outer zone is located under the connective tissue capsule and makes up the main part of the glandular parenchyma. It is here that a malignant tumor (prostate cancer) often develops - one of the most common oncological diseases in older men. The periurethral zone is a common site for the development of benign tumors (prostate adenoma), which are observed in more than 50% of men over 60 years of age. BPH leads to a narrowing of the urethra and, therefore, makes it difficult to empty the bladder.
Cooper's (bulbourethral) glands
Two Cooper's glands (glandulae bulbourethrales), each about the size of a pea, are located between the muscles of the pelvic floor (urogenital diaphragm). Their ducts empty into the proximal spongy urethra. The entry of the slightly alkaline secretion of these glands precedes ejaculation, neutralizing the acidic reaction of the urethral contents.
Composition of ejaculate
The main part of the liquid component of the ejaculate is formed in the prostate gland (25%) and in the seminal vesicles (75%). Seminal fluid is slightly alkaline and protects sperm from the acidic reaction of the vaginal contents. After three days of sexual abstinence, one ejaculation produces 3-6 ml of sperm, 1 ml of which contains at least 20 million sperm (normospermia). Among the sperm in one ejaculate, there are usually 10-20% that are not fully developed or deformed. If the sperm count in semen is less than 20 million/ml, we're talking about about oligospermia. The condition in which there are no sperm in the seminal fluid is called azoospermia.
Castration and sterilization
During castration, both testicles are surgically removed (for example, during treatment for a malignant testicular tumor). As a result, not only infertility develops, but also severe hormonal disorders. During sterilization, bilateral resection of the vas deferens is performed; Since the hormonal system continues to function, libido (sex drive) and potency (ability to have an erection) are maintained.
Urological pathologies cause patients a lot of unpleasant sensations, seriously reducing the quality of life of a modern man. Typically, such ailments occur due to bacterial infections or sexually transmitted diseases. Such pathologies include cooperitis, which is inflammatory in nature.
Cuperitis in men - what is it?
Cuperitis in urology is the inflammation of special glandular structures that are located in the bulb of the urethra. Cooper's gland is considered an exocrine structure responsible for the production of pre-ejaculate. This is a clear, viscous liquid that is released during a man's sexual arousal. The definition itself explains that the release of this secretion precedes ejaculation.
The Cooper's gland is localized in the transverse perineal muscle, and is usually no larger than a pea in size, inside which there are several microlobules surrounded by a fibrous layer.
Inflammation of these glands can be characterized by a chronic or acute course, and develops for quite a variety of reasons, which can only be established with proper diagnosis.
The pre-semen produced by these lobules is necessary to lubricate the internal cavity of the urethra in order to neutralize residual urine, remove foreign impurities and facilitate the movement of sperm through the urethra. Moreover, pre-ejaculate protects the urethra from the aggressive effects of urine. The amount of secretion secreted by the Cooper gland is very small - only a few drops.
Cuperitis occurs exclusively in men. Theoretically, women can also become infected with this pathology, however, they do not have Cooper’s gland, so women act only as carriers of such a disease.
The diagram shows the location of the Cooper gland
Forms
Experts identify several pathological forms of cooperitis:
- Follicular - occurs with blockage of the ducts due to inflammation, causing the formation of pseudo-abscesses;
- Catarrhal - when inflammation covers the surface structures of the glands and their excretory ducts;
- Paracooperitis - spread of inflammation to the tissue surrounding the Cooper glands;
- Parenchymal - when, against the background of retention of inflammatory products in the ductal canals, the lesion spreads to the interstitial and parenchymal glandular tissue.
Reasons for development
The main causes of the development of cooperitis are gonorrheal and trichomonas infections, infectious urethritis. At the same time, through the glandular ducts, the infectious pathogen penetrates into the organ, where it provokes active inflammation. Also, a common cause of cooperitis is bacterial infections of a nonspecific nature.
Symptoms
The follicular and catarrhal forms of cooperitis do not differ in serious structural disorders. With such lesions, when pressing on the gland, distinct pain occurs. With the development of parenchymal inflammation of the Cooper gland, men complain of perineal pain, which intensifies during movement or bowel movements.
When inflammation spreads to the surrounding tissue, urinary difficulties occur, and a painful swelling is felt in the perineal area away from the center line.
With paracuperitis, a swelling forms without sharp limitations, spreading to the scrotum. There is pronounced redness above the swelling, and when the swollen area is palpated, fluctuations in the fluid inside it are noted. The patient's general health deteriorates and a hyperthermic reaction develops.
When the acute course of cooperitis transitions into a chronic form, infiltrates, pseudo-abscesses or true cysts containing gonococcal microorganisms form in the inflamed Cooper glands. In the case of chronic inflammatory process, cooperitis is practically asymptomatic, although some men also experience pain when sitting.
Diagnostics
Diagnostic tests begin in the urologist's office. The specialist questions the man in detail about the troubling symptoms, then conducts a visual examination and palpation of the perineum, during which a nodular formation is detected.
- To detect the inflammatory process, laboratory biochemical and general clinical blood tests are performed.
- To determine the localization of the inflammatory and infectious process, laboratory testing of urine is indicated.
- To determine the pathogen, bacterial culture of the pre-ejaculate is carried out.
- If necessary, it is prescribed with contrast.
- The urologist can also refer the man to.
- Ultrasound examination and MRI of the perineal area are indicated.
How to treat
In general, the treatment regimen for inflammation of the Cooper glands depends on the severity of the pathological process, the form of the disease and the type of pathogen. Cooperitis therapy is based on antibiotic therapy and anti-inflammatory treatment.
If inflammation has developed to severe forms, then emergency measures are taken to eliminate the inflammatory process and its possible complications. When abscesses form, surgical opening is necessary.
Medication
The main therapy for inflammation of the Cooper glands still comes down to taking medications:
- Depending on the type of pathogenic pathogen, patients are prescribed drugs from the group of antibiotics for a two-week course.
- To prevent disruption of the intestinal microflora due to antibiotics, probiotics are prescribed.
- Symptomatic treatment is carried out using painkillers and NSAIDs, muscle relaxants.
- If, against the background of cooperitis, the development of autoimmune diseases occurs pathological conditions, then steroid hormone therapy is prescribed.
In addition to drug therapy, physiotherapeutic methods such as potassium iodide iontophoresis, massage stimulation of the Cooper gland and exercise therapy are also used. In case of acute inflammation, applying cold compresses to the site of inflammation is indicated.
Folk
Folk remedies for the treatment of cooperitis are used only in the early stages of the development of pathology and only as an addition to the main drug therapy. Sitz baths with chamomile infusion are quite effective.
Prognosis and complications
The pathology in general is rarely complicated and usually has a favorable prognosis. But if the disease is started, the inflammatory infection will develop to a deadly stage and bacteriological shock. Therefore, timely contact with a specialist, identification of the pathological process and its immediate treatment are so important.
In order to prevent the development of inflammatory lesions of the Cooper glands, it is necessary to take care of prevention, which involves eliminating sedentary activity, adherence to a regimen, giving up alcohol and smoking, regular sex life with a regular partner and timely treatment of genitourinary pathologies.
A man's menu must include dishes rich in pectin, fiber, and natural flavonoids.
But spicy and salty foods, sweets and smoked foods, as well as fatty foods should be excluded. After the age of 40, it is extremely important for men to undergo a preventive urological examination every six months, which will help to promptly detect and treat hidden pathologies.
), Kyiv, Ukraine
Introduction. Noninflammatory chronic pelvic pain syndrome or chronic prostatitis category III-B is characterized by the absence of an inflammatory response in the ejaculate, prostate secretions, and urine obtained after prostate massage (National Institutes of Health Consensus Classification - NIH, 1999). The accepted classification recognizes the limited understanding of the causes of this syndrome in most patients and the possibility that organs other than the prostate gland may play an important role as a causative factor in the development of this syndrome (Krieger J.N. et al., 1999).
Materials and methods. We observed 17 men with chronic pain in the pelvic area aged from 24 to 46 years (average 36.7 years), who had previously been treated for urethritis (3 patients), prostatitis (4) and urethroprostatitis (10) . In all cases, the reason for treatment was nagging, constant pain in the perineum, in some cases radiating to the area anus and the medial surface of the thighs, worsening after sitting on a hard surface, discomfort in the perineum after sexual intercourse, 4 (23.5%) patients noted frequent urination.
The duration of the disease ranged from 6 months. up to 5 years (on average 3 years 2 months). Before treatment for disturbing symptoms, one course of antibiotic therapy was administered to 3 patients, 2 courses to 5 patients, and 4 courses to 9 patients. Initially, the etiological factor of the inflammatory process was caused by gonorrhea, trichomonas, chlamydia, mycoplasma, bacterial and mixed infections. Eradication of pathogens was confirmed by cultural methods and polymerase chain reaction results. In all patients, using the standard method Meares E.M., Stamey T.A. (1968) demonstrated the absence of an increased number of leukocytes and microorganism cultures in all studied samples (1st and 2nd portions of urine, prostate secretion, 3rd portion of urine), as well as in the ejaculate. All patients underwent ultrasound examination of the pelvic organs (transabdominal and transrectal), uroflowmetry, 10 men underwent anterior urethroscopy, 4 - urethrocystoscopy. Three men underwent computer (1) or magnetic resonance (2) tomography of the pelvis. Based on the examination results, no structural changes in the pelvic organs were found.
In order to determine the condition of Cooper's bulbourethral glands (Cowper), we applied a modified method of Meares E.M., Stamey T.A.. The peculiarity was that after the 1st portion of urine, the Cowper glands were massaged, and the 2nd portion of urine contained the secretion of the Cooper glands, actually reflecting their condition. After this, prostate secretion and a third portion of urine were obtained. Isolated inflammation of the bulbourethral glands was indicated by an increased content of leukocytes (more than 10 per field of view) in the 2nd portion of urine, while in the 1st and 3rd portions of urine and in the prostate secretion the number of leukocytes was within normal limits.
Results and discussion. When conducting a modified test, Meares E.M., Stamey T.A. 6 patients were diagnosed with cooperitis. Considering the significant length of the excretory ducts of the bulbourethral glands and the possibility of their obstruction by viscous secretions, the remaining 11 men underwent a course of systemic enzyme therapy and massage of the Cooper glands and prostate gland, after which the test was repeated. Another 4 patients had inflammation of the bulbourethral glands. Thus, of the 17 patients with non-inflammatory chronic pelvic pain syndrome who had previously been treated for urethritis, prostatitis or urethroprostatitis, 10 (59%) had inflammation of the Cooper glands. The bacteriological study made it possible to establish that the etiological microbial factor of cooperitis was: E.faecalis, E.faecium, E.coli, K.pneumonia, E.aerogenes. To assess symptoms in patients with diagnosed pathology of the bulbourethral glands, the National Institutes of Health Chronic Prostatitis Symptom Index - NIH-CPSI (Litwin M.S. et al., 1999) was used. The initial quantitative values left 31.3 points.
Patients with diagnosed inflammation of the bulbourethral glands received a course of antibacterial therapy taking into account the sensitivity of the isolated pathogens against the background of physiotherapeutic procedures and digital massage of the Cooper glands. The treatment led to a decrease in the total symptom score by 23.8 points and amounted to 7.5 points at the end of treatment. Normalization of the number of leukocytes in a portion of urine obtained after massage of the Cooper glands was achieved in 8 (80%) patients, sanitization of the bulbourethral glands from microorganisms was ensured in 7 (70%) men.
Cooper's bulbourethral glands are complex tubular glands and range in size from 3.5 to 10 mm. They are located in the thickness of the urogenital diaphragm and are adjacent to the posterior wall of the membranous part of the urethra, and their excretory ducts open in the bulbous part of the urethra. The significant length of the excretory ducts is from 2 to 8 cm, and the possibility of their obstruction with secretions makes diagnosis difficult and requires re-examination of the ejaculate and a portion of urine after massage of the Cooper glands.
Chronic cooperitis does not have a clearly defined clinical picture; hardware and instrumental diagnostics of the condition of the bulbourethral glands are not sufficiently developed. In the diagnosis of inflammatory diseases of the Cooper glands, it is advisable to focus on data from a digital rectal examination, analysis of a portion of urine obtained after massage of the Cooper glands, and to assess the severity of symptoms and the effectiveness of treatment, the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI, 1999) can be used.
Conclusion. The findings indicate that chronic pelvic pain syndrome is heterogeneous in nature. In some cases, the non-inflammatory syndrome of chronic pelvic pain may hide an inflammatory process in the Cooper glands. This is especially true for patients with a history of urethritis or urethroprostatitis of an infectious nature. Studying the causes leading to the development of chronic pelvic pain syndrome will allow optimizing treatment tactics and individualizing therapy depending on the causative factor.
Andreev Andrey Alexandrovich
http://www.prosto-prostata.com.ua
[email protected]
Tel. mob. +380674042322
Head dept. Urology of the Central Hospital of the Ministry of Internal Affairs of Ukraine
Ukraine, Kyiv, st. Berdychevskaya, 1
Tel. +380444815632
(synonym - bulbo-urethral glands), a paired glandular organ located in the thickness of the urogenital diaphragm above the bulb of the corpus spongiosum of the penis; homolog of Bartholin glands.
The glands are spherical (about 1 cm in diameter), tubular-alveolar, located almost side by side (sometimes touching), separated by fibers of the deep transverse muscle of the perineum, which surround them on all sides. The left gland is often more developed. They can be felt through the perineum only during inflammation, when they are significantly enlarged. Each gland has an excretory duct 3-6 cm long, opening with an opening in the bulbous part of the urethra.
The secretion of the glands is colorless, transparent, odorless mucus with an alkaline reaction, released into the urethra during sexual arousal due to contraction of the perineal muscles. When passing through the urethra, the secretion neutralizes the acidic reaction of the urine remaining in it and, released from the external opening of the urethra, facilitates the insertion of the penis into the vagina. With age, glandular hypotrophy is observed. Inflammation of the Cooper glands (cooperitis) occurs most often with gonorrheal and non-gonorrheal urethritis.
Rice. Cooper's glands. Schematic representation of digital examination of Cooper's glands: 1 Cooper's glands; 2 urethra; 3 prostate gland; 4 bladder; 5 rectum.
(Source: Sexological Dictionary)
See what "Cooper's glands" are in other dictionaries:
COOPER'S GLANDES- COOPER'S GLANDS, more correctly Cowper (W. Cowper) (glandulae bulbo urethrales Cow peri), were described for the first time in 1684 by Cooper. Winslow called these same glands “antiprostate” (Braus). They are a paired glandular organ,... ...
- (synonyms paraurethral glands, glands of the urethra, urethral glands), grape-shaped tubular alveolar glands of the urethra. In men, they are located along the entire length of the urethra, from the external... ... Sexological encyclopedia
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Men's internal organs in the pelvic area. 1 bladder 2 pubic bone; 3 penis; 4 corpus cavernosum ... Wikipedia
BENIGN BREAST CONDITIONS- honey Benign conditions of the mammary gland are clinically manifested by complaints of pain, changes or discharge from the nipple, and the presence of any formation in the gland. Mastodynia (mastalgia, Cooper's disease) pain in mammary gland. In women in... ... Directory of diseases
I Medicine Medicine system scientific knowledge and practical activities, the goals of which are to strengthen and preserve health, prolong the lives of people, prevent and treat human diseases. To accomplish these tasks, M. studies the structure and... ... Medical encyclopedia
URETHRA- URINARY CHANNEL. Contents: Anatomy.........................174 Research methods..................178 Pathology....... .............183 Anatomy. The urethra, urethra, urinary tube, is a continuation of the bladder and... ... Great Medical Encyclopedia
- (pre-semen, or Cooper's fluid) is a clear, colorless, viscous pre-sperm fluid that is secreted from the urethra of a man's penis to the outside when he becomes sexually aroused... Wikipedia
CONNECTIONS- LIGAMENTS, ligamenta (from the Latin ligo I knit), a term used in the normal anatomy of the ligaments of humans and higher vertebrates primarily to designate dense connective tissue cords, plates, etc., complementing and reinforcing one or... ... Great Medical Encyclopedia
Wikipedia has articles about other people with this surname, see Cooper. Gary Cooper Gary Cooper ... Wikipedia
Figure 1.Figure 2.
Figure 1.1-Gl. bulbo-urethralis dextra; 2-bulbus urethrae. Figure 2. 1- symphysis os- pubis; 2-gl. bulbo-urethralis; 3 -m. transvers. perinaei pro-fund.; 4- urethra (pars membranacea). - glandular tissue is crushed, so that the latter loses its shape and is macroscopically hardly noticeable. Both glands lie quite close to each other and are sometimes connected to each other by a bridge of muscle fibers, forming an isthmus. Excretory duct of the gland, 5-6 long cm, ends with a slit-like opening in the fossa bulbi urethrae (Fig. 3) (Braus). Along with these K. zh. another 1^ and additional glands are observed. (gl. Cowperi,*£= accessoriae) with trailing ends zSh ducts (Fig. 4) (Lichtenberg). Microscopic examination showed 3g of the blood. (Fig. 5) It is clear that the secreting epithelium lines not only the terminal branches of the gland, but even the walls of the excretory duct to the point where it flows into the urethra. The cells lining the walls of both the main and terminal tubules are single-layer columnar epithelium, which is similar to the epithelium of the mucous glands and stains with hematoxylin in blue. The mucus contained in them does not settle when treated with vinegar. At the blind end of the gland, the terminal branches arise much more often; they are larger and expand in the form of ampoules, which are a repository for gland secretions (Fig. 4 and 5) (Braus). -Functions of the gland. have not yet been clarified. Invisible when ejecting semen from the urethra. channel contents K. under the influence of contraction of smooth and striated muscles, it leaves the excretory duct and mixes with the ejaculate. Some suggest that the contents of these glands are covered by Figure 3. Glandula bulbo-urethr. (1); 2-pars mem-bran. urethrae; 3 -d. ex-creator. gi. Cowperi.
Figure 4. Gl. bulbo-ure-thrales(i- gl. accessor.).
It forms a protective layer on the mucous membrane of the urethra, protecting the walls of the canal from irritation by URINE residues. R. Herzenberg. Cooperitis (cowperitis), inflammation of the genital tract, was first described by Gubler in 1849. Recently, cooperitis, especially gonorrheal, has rightly received a lot of attention in Western and in our literature. The gonorrheal gland due to its anatomically close contact with the urethra reflect the state of the latter. Inflammation of the K. glands can occur by direct transfer of infection per continuitatem from the urethra, as is the case with gonorrheal and so-called non-gonorrheal, or catarrhal urethritis. Hematogenous and lymphogenous routes of infection are observed much more. less often, for example with tbc (single observations). If Ricord counted 6 cooperites per year in his huge practice, then one must think that he had in mind only abscesses of this organ in a large series of autopsies. of persons suffering from chronic gonorrhea, proved that cooperitis occurs as often as prostatitis. In acute gonorrhea, Muhlpfordt found cooperitis in 15% of cases, and Shishov and Smirnov in 12% of cases. Pathologically and anatomically, we are talking about catarrhal or purulent inflammation, sometimes with the formation of retention cysts. A special stalemate. the form is represented by independently developing cysts. Cuperitis disease is often one-sided. Usually the process goes unnoticed, and only later, when prolonged gonorrhea forces you to carefully look for the cause, does methodical and systematic eating lead to cooperitis. Diagnosis is made primarily based on palpation. Study of K. according to Picker, it is performed either in a horizontal or in a knee-elbow position. The index finger is inserted into the rectum, bent with a hook and then try to connect its end with the end of the thumb of the same hand. bringing your thumb to the gland from the side of the perineum. Between the ends of both fingers, the inflamed gland can be clearly felt and appears painful. If, during inflammation, a long 
Figure 5. Structure of K. t.: 1- columnar epithelium; 2 and 4- smooth and striated muscles; 3 -ampulla.
The water duct remains open; it turns out that it is possible to squeeze out the secretion of the gland through massage and subject it to examination. The massage is performed in such a way as not to touch the prostate: the urethra is first washed and the bladder is filled with an indifferent solution. During inflammation, pus and microorganisms are found in the secretion. When swelling closes the lumen of the excretory duct, acute couperitis occurs, accompanied by a number of symptoms: stabbing pain in the perineum, the formation of a tumor that makes urination difficult, an increase in temperature and sometimes the opening of the formed abscess. Urinary infiltration may also have an abscess as its primary source. Chron. cooperitis usually occurs without symptoms; Less commonly observed is pain when sitting on hard objects and the appearance of discharge from the urethra not in the morning, but after walking, in the evening. In addition to palpation in chronic In cases of diagnosing, urethroscopy and urethroradiography can help. With the first, dilatation and inflammation of the mouth of the vein is visible, and with the second, it is filled with contrast liquid. - Treatment: in acute forms, rest, heating pads; for an abscess - a wide incision; for chronic cooperites-massage, bougienage, different types heat, in persistent cases - extirpation. - Prevention of couperitis is timely and correct treatment of urethritis.i. Shishov. Lit.: Braus H., Tiber den feineren Bau der Glandula bulbo-urethralis (Cowperschen Druse) des Menschen, Anat. Anz., Band XVII, 1900; Lichtenberg A., Beitrage zur Histologie, mikroskopischen Anatomie und Entwicklungsgeschichte des Urogeni-talkanals des Mannes u. seiner Driisen, Anat. Hefte, B. XXXI, 1906; Rammstedt C, Die Chirurgie der mannlichen Harnrohre (Hndb. d. praktischen Chirurgie, hrsg. t. With Garre, H. Kuttner u. E. Lexer, B. IV, p. 981, Stuttgart, 1927). Cuperitis.-S Mirnov N. and Shishov I., About chronic gonorrheal cuperitis, Venereology and Dermatology, 1924, No. 6; Leszynski R. Sur la cowperite chronique latente, Ann. d. mal. vener., t. XVII, 1922; MiihipfordtH., tjber die Haufig-keit der Cowperitis gonorrhoica, Ztschr. f. Urologie, B. XVII, 1923.
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