KINESITHERAPY kidney diseases and urinary tract

Permanent removal from the organism of decay products and other harmful substances carried the genitourinary system.

Urogenital apparatus comprises two organ systems, anatomically and physiologically different, but closely related topographically to their origin and functions (in part).

To the male genitalia (Fig. 88) are the testes (testicles), penis and prostate and additional channels by which the secrets of the prostate, testes and seminal vesicles come into the penis.

Fig. 88.  Medisection male pelvis: 1 - caul, 2 -  umbilical ligament, and 3 - the bladder, 4 - median space that lies behind pubis, 5 - pubic symphysis, b-prostate; 7 - epididymis, 8 - testis, 9 - ledge, Cape, 10 - recto-vesical cavity, 11 - rectum; 12 - seminal vesicle; 13 - crotch curve; 14 - pelvic diaphragm, 15 - right-vesical septum; 16 - male muscle, contracting the anus

Genito-urinary system includes the kidneys with renal pelvis, ureters, bladder and urethra.

Comprehensive system of rehabilitation involves the use of exercise therapy, massage, physiotherapy and hydrotherapy, massages, diet therapy, spa treatment, etc.

 Urolithiasis

Urinary stone disease is caused by metabolic disorders. It can be shown only malosimptomno and unstable red blood cell, sometimes dull pain. A typical manifestation of urolithiasis - renal colic as a result of displacement of stone: there is strong sharp pain followed by gross hematuria (unmodified red blood cells), sometimes with separation of the stone. Characterized by sharp pain in lower back effleurage on the affected side. Urolithiasis is often complicated by chronic pyelonephritis.

A role in the etiology of urolithiasis play a violation mochekislom, phosphate and oxalate metabolism, as well as infection, urinary stasis, slowing renal blood flow. The latter violates the secretory function and reabsorbtsionnuyu renal epithelium, followed by separation of pathological proteins that make up the organic matrix - the bed rock of the future.

With urolithiasis is an increase in arteriolar tone due to narrowing of the income and efferent vessels.

Rehabilitation: in the acute period of Hyperthermic bath (38-43 ° C), analgesics, antispasmodics. Shows the sauna (bath), followed by taking warm shower or bath (the temperature above 38 ° C). You should not swim in cold water! Needed diet and appropriate medication. In the interictal period recommended massage with warm oil (eucalyptus, olive and fir), or massage brush to hyperthermal bath, as well as gymnastics, skiing, cycling (or classes on a stationary bike), the combination of running with walking and then taking copious drinking and hyperthermal bath.

Provocative aspect of renal colic are often increased physical strain or jarring of the body (riding a bike, swimming in cold water, etc.). In such cases shows Hyperthermic bath and massage.

The problem of massage: to analgesic effect, remove the spasm, to improve the metabolic processes in tissues and blood flow in the kidney. Recommended massage giperemiruyuschimi ointments in the lumbar region, buttocks, lower limbs, abdomen, or massage brush to hyperthermal bath (water temperature 38-43 ° C). It is also heavily massaged (to rub) segmental zone T _11-12 - L _1-3.

  Prostatitis. Prostate adenoma

Inflammation of the prostate (see Fig. 88), or prostatitis can be acute or chronic. In chronic prostatitis growing fibrous tissue, there is hypertrophy of the prostate. Formed in prostate adenoma comes from her own tissue and located between the mucosa and muscle layer of posterior urethra and bladder neck. Adenoma of the prostate gland makes a spectacle mucosa into the lumen of the prostatic urethra and bladder neck, and muscular layer pushes it outwards. As a result, difficult urination.

It is known that in the acini of the prostate gland in their excretory ducts, the mucous membrane of the prostatic urethra laid by free nerve fibrils in the smooth muscle - terminal plexus, and between slices of cancer are complex organellar education. Secretory hypogastric nerves are most relevant to the glandular tissue.  The capsule of the prostate revealed a large number of nerve endings that form a powerful prostate plexus. In addition to the overall innervation of the prostate gland has its own autonomous specific innervation.

Disorder of innervation and hemodynamics in the prostate gland leads to functional changes with its clinical autonomic dystonia.

Non-infectious inflammation of the prostate due to stagnant, or congestive, etiological factor. Pathogenetic factor may be immune processes in response to cold and other irritants. By noninfectious prostatitis include congestive prostatitis, acute congestion of prostate cancer and other diseases.

Congestive prostatitis is common among athletes, sailors, deep sea, etc. It is characterized not only by the absence of bacterial flora in the prostate gland secretions, but also the presence of stagnation in most prostate and pelvic veins.  Stagnation of secretions in the prostate gland may occur with prolonged sexual abstinence, lack of wet dreams and masturbation. The result is often observed minor sexual offenses, especially in young men, which can lead to nervous disorders.

Stagnation of secretions in the prostate gland and seminal vesicles and contribute to various dysrhythmia sexuality (interrupted sexual intercourse, sexual excesses, prolonged abstinence, the lack of regularity and rhythm of sexual life, sexual abstinence).

As a result of defective ejaculation occurring under the influence of stressful situations during intercourse, and other reasons, too, developed chronic congestive venous congestion of the prostate. Venous stasis in the pelvis may be due to the expansion and phlebitis hemorrhoidal veins, proctitis and other inflammatory processes.

Conservative treatment includes massage of the prostate, gymnastics, walking and jogging, skiing, swimming, diet, fortification of foods. Fig. 89 shows an exemplary set of exercises in prostatitis.

The problem of massage: the elimination of stagnation, accelerating blood circulation and lymph flow in the prostate and pelvic organs, the removal of mental and emotional stress.

Massage technique. IP —  Wear rubber gloves, finger smeared with petroleum jelly and inserted into the colon. Produce friction, soft pressure on the gland. Finger movement should circumvent each of the side fractions of the prostate in a figure 8 with a slight inward and downward nadavlivaniem (Fig. 90). Duration of the massage for 1-2 minutes. Massage should not be rude. Before the massage prostate massages the lumbar region, buttocks, back, thighs, and then the abdomen, groin area.

Fig. 89. Approximate complex K for prostate

Fig. 90. Urological massage: a - a massage of the prostate gland, b - diagram of the structure of genital organs and prostate massage

Nephroptosis

Nephroptosis - the omission of the kidney. The kidney is not a fixed body: breathing, change in body position, physical stresses, it can be moved downwards, its vertical, sagittal or frontal axis.

Lack of flexibility fascial sheets, weak or strong adipose capsule weight loss significantly affect the mobility of the kidney. Fascial weakness plates are often a manifestation of a common disease of connective tissue. Along with nephroptosis observed prolapse and other organs (stomach, uterus, anterior vaginal wall), then there is a general splanhoptoz. Nephroptosis occurs predominantly in women, especially in a lot of giving birth. Men nephroptosis occurs about 10 times less often than women.

Nephroptosis is often the result of trauma - a blow to the lumbar region, bruised her during a fall, a sharp shake of the body in the fall, a strong reduction of the abdominal muscles with excessive physical exertion. All of these can cause significant displacement of the kidney due to violation of the integrity of pararenal fascia and fibrous bridges.

Dipped bud appearance is not changed, but the vascular pedicle, it is usually elongated. Frequent displacement of the kidney accompanied by venous stasis due to renal vein inflection. Circulatory disorders cause dystrophic changes in the kidney in the form of proliferation of interstitial tissue.

If there nephroptosis pain, diarrhea and nervous disorders, dysfunction of adjacent organs, reduced working capacity.

Along with exercise therapy (you need a special set of exercises while lying on his back on the couch with the foot elevated) massages the back, abdomen, thighs. Chopped and effleurage excluded. Duration of the massage 10 - 15 min. Course of 15-20 procedures. In the year of 3-4 courses.

Pyelonephritis

Pyelonephritis - an inflammation of the renal pelvis, bacterial proliferation in the interstitium and parenchyma of the kidney.

Contribute to the development of pyelonephritis and urolithiasis impaired patency of the urinary tract of different nature, of prostate diseases, pregnancy, diabetes, abnormalities of the urinary tract, and their dyskinesia.

Pyelonephritis can be acute or chronic.

Rehabilitation includes: in the acute stage - drug therapy, diet, chronic form of pyelonephritis in the exacerbation should be conducted as medication, diet, followed potable mode. In what must be follow-up, long-term use of lung uroantiseptika (kidney tea, cranberry extract) shows moderate exercise: gymnastics, horse-country skiing, walking, cycling or training on a stationary bike, etc. We recommend a sauna (bath), followed by a warm reception soul (excludes swimming in the pool, swimming in the waters!), holding the massage with warm oil or massage brush in a warm bath (temperature not lower than 38 ° C), or manual massage in the bath. Massage course of 15-20 procedures.

Massage in pyelonephritis: massage your back, lumbar region, buttocks, abdomen and lower extremities with giperemiruyuschih ointments. Excluded percussion techniques. Duration of the massage for 8-10 minutes, the course of 10-15 procedures. In chronic pyelonephritis shows manual massage and massage brush in the bath (water temperature not lower than 38 ° C), 2-3 treatments per week.

Functional sexual disorders in men

In the pathogenesis of sexual disorders is of great importance stress that arises and becomes stable in the identification of sexual inadequacy (disharmony). When sexual disharmony related to physiological causes, disorders are often caused by neurosis. If there are inflammatory diseases of the prostate and seminal vesicles, violations of the neuro-vascular regulation, diabetes, need complex treatment. Sexual dysfunction in men characterized by sleep disorders, headaches, etc.

Disorder of sexual function should be viewed from the standpoint of the general theory of functional systems PK Anokhin.

In the reproductive system are 4 functional complex:

neurohumoral - associated with the activity of deep brain structures and the whole system of endocrine glands;

psychological - associated with the activity of cortical systems;

Penis - associated with spinal erection center and ekstraspinalnymi divisions;

ejaculatory - anatomical and physiological complex, including the prostate gland with its specific innervation.

When neurogenic (neurotic) impotence massages, MH, swimming, skiing, sauna, etc.

The problem of massage: the optimization of metabolic processes in tissues, nerves and vessels of reproductive organs, as well as the normalization of the mental and emotional state of sleep.

Massage technique. Massages the back, lumbar region, buttocks, inner thighs, prostate, and the impact of exciting method on ABC (see "Acupressure"). Apply vibration massage paravertebral areas and special vibratodami affect BAT lumbar region.

Menopause in men

With age, there are structural changes in the tissues of the sex glands to the growth of fasteners, whose sensitivity to hypoxia is much lower than the seed of the epithelium and interstitium of testes.

We can assume that the climax - a physiological syndrome, age-related changes in hormonal and general exchange and above all age-fading function of sexual glands. In men it occurs later than in women, occurs less markedly and merges with the signs of aging.

Symptoms of menopause in men occur in different age groups in various degrees. But all of a change in hormonal levels and the consequent restructuring of mental and neurohumoral components. The presence of the asthenia confirmed complaints shake serried eyelids and fingers outstretched hands, increased tendon reflexes, an alarming suspiciousness.

Male menopause symptoms: fatigue, a decrease (reduction) of physical and mental capacity, the weakening of memory, sudden hot flushes, sweating, aches and pains angiospastic nature, reduced sexual activity. There are also violations of the CNS and the autonomic nervous system, marked by disturbances of functions of visceral organs, changes in metabolism, neuroendocrine diskorrelyatsiya, fluctuations in blood pressure, heart rate, vascular responses.

All these changes are accompanied by neurotic reactions to the appearance of stagnant pockets of excitation and abnormal enhancement of the efferent impulses that lead to the excitation of vasomotor center of the hypothalamus, the pituitary release of vasopressin, which, in turn, increases the sympathetic impulses and changes the state of vascular tone.

Comprehensive rehabilitation in functional sexual disorders include massage, moderate exercise (skiing, cycling, swimming, games, etc.), exercise therapy, massage, sauna and other facilities.

Since menopause is closely linked with the mechanisms of aging, moderate physical education, exercise therapy, massage, diet is primarily aimed at the prevention of aging and the normalization of mental and emotional state.

The problem of massage: normalize cortical neurodynamics, autonomic dysfunction, to restorative and trophic effects, improve metabolism.

Massage technique. Reflex effects on the adrenal glands (massage the lumbar region, where they exit the spinal nerves), massage the muscles of the abdomen, lower extremities, resulting in the thigh muscles. Using MH, massage with oxygen therapy. Soundlights govern psycho-emotional state, and metabolic processes in tissues so that the pituitary-adrenal system operates with a lower voltage.

Massage and LH designed to improve circulation in the pelvis, as eregirovannost penis depends on the dynamics of blood circulation in the pelvis. Moderate physical training, diet, sauna (bath) help to normalize the patient's mental and emotional state.