About the injury
The prostate gland in men is located below the bladder and is responsible for producing sperm. In the event of an injury to the pelvic floor area, there is a high risk that both the prostate gland and the urethra will be damaged, since they are anatomically very close to each other. The urethra is the tube that transports urine from the bladder to the meatus (outside opening). If either the urethra or the prostate are injured, nearby organs may also have been damaged.
There are two types of injuries to the prostate: open and closed. An open trauma describes an injury caused by an external object that cuts or punctures the body and causes bleeding, such as a stab or gunshot wound, or accidental damage during surgery. It is important to regularly undergo imaging tests following abdominal surgery, in order to make sure that the surrounding organs have not been affected by the medical intervention. In some cases, trauma can occur as a result of a prostate biopsy, when a small sample of tissue from the prostate is acquired in order to examine it more closely under the microscope. A biopsy is a necessary procedure if it is suspected that cancerous cells are present.
A closed trauma of the prostate gland can occur as a result of an injury to the pelvic area, such as a kick to the groin in a fight. Even if everything looks fine from the outside and there is no evidence of bleeding, serious internal injuries could actually have been sustained. If so, the injured person is likely to suffer sharp pain in the pelvic area. In this case, urgent medical treatment may be required.
Symptoms
- Acute pain in the penile and pelvic area
- Acute pain in the lower back
- Pain when urinating
- Pain when ejaculating or having sexual intercourse
- Blood in the sperm or urine, in some cases
- Dizziness
- Confusion
- Fever in some cases
Diagnosis
- At the hospital emergency room, the doctor will ask the patient what kind of trauma he sustained, because different injuries require different treatment approaches.
- If the patient was not involved in a fight or did not sustain an obvious injury, the doctor will go through his medical records and laboratory tests, to investigate the possibility that the trauma occurred as a result of a previous surgery or other medical procedure.
- If the patient’s symptoms are conducive to an injury of the prostate, the doctor will need to perform a physical examination. This usually involves palpation via the rectum.
- An ultrasound, MRI scan or an X-ray can help doctors to determine the kind of trauma the prostate and surrounding tissue has sustained, and how serious the injuries are.
- A cystoscopy may be necessary if it is suspected that the urethra and bladder have also been damaged.
Treatment
- Conservative treatment, such as the use of antibiotics and analgesics can be useful to treat any resulting infections, and alleviate the pain.
- An operation is crucial if there is any internal bleeding. The surgeon will remove any foreign bodies that may be present and performs drainage and sanitation of the wound before repairing the damaged areas.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
