tailieunhanh - PROSTATIC DISEASES - PART 4

Đối với lý do chưa được hiểu rõ, tuyến tiền liệt có vẻ đặc biệt dễ bị viêm mãn tính. Trong khoảng 10% các trường hợp, đây là kết quả của một loại vi sinh vật lây nhiễm vi khuẩn, chlamydia hoặc khác. Đối với 90% còn lại các trường hợp, tuy nhiên, không có nguyên nhân rõ ràng etiological vẫn chưa được xác định. | 10 Inflammatory processes and the prostate For reasons not yet understood the prostate seems especially prone to chronic inflammation. In approximately 10 of cases this is the result of a bacterial chlamydial or other infecting microorganism. For the remaining 90 of cases however no definite etiological cause has yet been identified. Prostatic ducts and the acini into which they branch see Figure 5 are the foci of these inflammatory processes. A number of non-infective etio logical factors may be involved. When inflammation does occur the subsequent chronic prostatitis affects the peripheral zone more often than the central zone of the gland. One explanation for this may be that peripheral zone prostatic ducts enter the prostatic urethra at a less oblique angle than do central zone ducts. This may render the peripheral zone ducts more susceptible to intraprostatic reflux of urine during micturition Figure 37 . Figure 37 Prostatitis is characterized by the development of chronic inflammation especially involving the peripheral zone of the prostate. Intraprostatic reflux of urine into the horizontally situated peripheral zone ducts may be one of the triggering mechanisms involved 40 INFLAMMATORY PROCESSES AND THE PROSTATE Studies using intravesical instillation of India ink prior to voiding and subsequent prostatectomy have revealed an intraprostatic finding of carbon particles Figure 38 and have also demonstrated their subsequent ingestion by macrophages23 Figure 39 . Urine reflux into prostatic ducts Figure 40 may not only be one mechanism of induction of chronic inflammation but may also be the cause of intraprostatic calculus formation Figure 41 . Studies have revealed that whereas many prostatic calculi Figure 38 Carbon particles India ink placed in the bladder and subsequently voided could be demonstrated in the prostatic ducts of patients who subsequently underwent prostatectomy Figure 39 Fluid expressed from the prostatic ducts several days after placement of

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