ANAL FİSSÜR, BENİGN PROSTAT HİPERPLAZİSİ, PENİL AĞRI, DİSÜRİ BİRLİKTELİĞİ

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:

anal fissür, penil ağrı, dizüri, BPH

Anal Fissure, Benign Prostatic Hyperplasia, Penile Pain, Dysuria Co-Occurence

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.

Keywords:

Anal Fissure, Benign Prostatic Hyperplasia, Penile Pain, Dysuria,

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Adil E. Bharucha, Tae Hee Lee, MD. Anorectal and Pelvic Pain. Mayocp. October 2016Volume 91, Issue 10, Pages 1471–1486
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