The article deals with the main causes of chronic pelvic pain syndrome (CPPS), some of its pathogenetic mechanisms are depicted. It is noted that at the present time, CPPS, despite its considerable prevalence, remains poorly understood by a disease that is difficult to treat, the adequacy of which is possible only under the strict topical and nosological diagnostics. To date, there are no clearly identifiable etiological factors in the development of CPPS, and existing contradictory data regarding diagnostic criteria significantly reduce the possibility of a clear diagnosis. In addition, there is still no single approach to choosing the best treatment methods for CPPS, and the assessment of a large number of existing treatments for this disease is difficult due to the lack of a standardized system for evaluating the results of treatment. These circumstances, together with the steady course of the disease, lead to the formation of neurotic conditions, which emphasizes not only the purely medical but also the social significance of the problem of increasing the effectiveness of diagnosis and treatment of CPPS in boys at the present stage. The algorithm of diagnostics and treatment of CPPS is proposed, which is based on an individual and comprehensive examination of patients by multidisciplinary interaction with specialists of other specialties related to a specific case that allows choosing pathogenetically grounded treatment tactics
In order to prevent and correct the defecation disorders after destruction of the anococcygeal ligament, the meth-od of restoring its functional capacity was proposed (Patent of Ukraine for Invention No. 115280 “Method for Coccyx Re-moving”). It is proved that the damaging effect in the area of the traction and contraction mechanism of action on the rectum in 90.0% leads to continence disorders due to changes in the size of the anorectal angle due to the persistent disorders of the anococcygeal ligament function. The developed special mathematical model of the anococcygeal ligament function testifies that, when it is destroyed, the change in the anorectal angle value may reach changes in its value up to ≈63°, which distorts the direction of the anal canal and the distal rectum. Restoration by simulating of the anatomical fixation of anococcygeal ligament connection after its damage creates conditions for resto-ration of its physiological functioning.
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