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"lead": "онкологическое заболевание, которое связано с развитием злокачественного новообразования в эректильной (пещеристой) ткани",
"description": "<p><span id=\"docs-internal-guid-0c3346f7-7fff-c66c-a6ac-46f5b4baf027\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Рак полового члена — это онкологическое заболевание, при котором злокачественная опухоль, происходящая из эпителиальной ткани, локализуется в области головки, крайней плоти или тела пениса.</span></span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Механизм развития рака полового члена изучен не до конца. Определенную роль играют хронические заболевания половых органов, особенно в сочетании с курением и регулярными нарушениями правил личной гигиены. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Предрасположенность к заболеванию обуславливают следующие состояния:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">фимоз – сужение крайней плоти;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">носительство папилломавируса;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">доброкачественные образования в области половых органов;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">положительный ВИЧ-статус.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Риск развития онкопатологии пениса выше у гомосексуалистов и мужчин, которые часто меняют половых партнеров и пренебрегают методами барьерной контрацепции.</span></p>",
"pathogenesis": "<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">В патогенезе рака полового члена основное значение придается застою содержимого препуциального мешка, чаще всего возникающему при фимозе. Присоединение инфекции, длительное воспаление, скопление продуктов распада смегмы способствуют развитию заболевания.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфических маркеров для онкологии пениса не выделено. Если врач при первичном осмотре обнаруживает признаки злокачественной опухоли, то проводится комплексное обследование. Биопсия необходима для определения природы заболевания. Для диагностики рака пениса обычно достаточно аспирационной пункции тонкой иглой (PAAF). Ложноотрицательные результаты встречаются до 50% случаев.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для диагностики рака полового члена назначаются следующие лабораторные исследования:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">общий и биохимический анализ крови;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">коагулограмма;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">общий анализ мочи;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">микробиологическое (культуральное) исследование.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для уточнения диагноза проводится биопсия ганглия. КТ назначается для исследования расширения и локализации поражений. Метастазы чаще всего наблюдаются в легких, печени и костях. Для стадирования назначается ультразвуковое исследование, МРТ, а также лимфангиография и кавернозография.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Хирургическое вмешательство проводится в большинстве случаев. Тип операции зависит от размера опухоли и ее положения на половом члене. Если злокачественное образование небольшое и ограничено только кожей полового члена, то опухоль и небольшое количество нормальной ткани могут быть удалены.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если рак поражает большие участки, может потребоваться удалить часть полового члена или даже ампутировать весь пенис. Лимфатические узлы паха также удаляются во время операции.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В дополнение к хирургическому лечению назначается химио- и лучевая терапия, чтобы удалить остатки раковых клеток. Если рак находится на ранней стадии и локализуется только в головке полового члена, иногда врачи назначают цитотоксический крем.</span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфических методов профилактики рака полового члена не существует. Для снижения риска развития заболевания врачи рекомендуют отказаться от вредных привычек, рационализировать режим дня, вести активный образ жизни, своевременно и в полном объеме лечить урологические заболевания, а также отказаться от случайных сексуальных связей. Всем совершеннолетним мужчинам стоит ежегодно проходить урологическое обследование.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее распространенными признаками рака полового члена являются изменения, которые влияют на кожу, покрывающую пенис: обесцвечивание, утолщение или комки.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптомы рака пениса:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">выделения, иногда неприятный запах;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">необъяснимая боль в крайней плоти;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">воспаленные участки, красноватые высыпания, шишки со струпьями или опухоли необычного цвета;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">опухшие лимфатические узлы в паху (паховая аденопатия).</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эти симптомы могут проявляться и при других расстройствах, не связанных с раком, но необходимо обратиться к врачу, т. к. рак на ранней стадии также начинается с этих признаков.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если своевременное лечение отсутствует, то рак прогрессирует и включает всю поверхность головки и/или крайней плоти. Затем атипичные клетки распространяются на более глубокие части полового члена и другие области тела.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптомы прогрессирующего рака полового члена на 3 и 4 стадии:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">опухоль внешне похожа на цветную капусту;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ощущается чрезмерная усталость;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">присутствует боль в области живота;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">отмечается дискомфорт в костях;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">имеет место беспричинная потеря веса.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Измененный участок имеет вид язвочки, эрозии, узелка, бляшки или бородавки. Патологический очаг постепенно увеличивается в размерах, уплотняется и приводит к фимозу. Появляется характерный зуд, боли при мочеиспускании. Из препуциального мешка выделяется зловонный секрет.</span></p>",
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"lead": "это злокачественная опухоль, развивающаяся, как правило, из ткани желез простаты. Как и другие злокачественные опухоли, рак простаты имеет тенденцию к метастазированию (распространению по организму).",
"description": "Рак предстательной железы является одним из самых распространенных онкологических заболеваний у мужчин. По данным медицинских исследований рак простаты является наиболее частой причиной смерти мужчин пожилого возраста. Тем не менее при раннем выявлении рак простаты успешно лечится, а современные методы терапии позволяют приостановить болезнь и продлить жизнь мужчины на долгие годы.",
"etiology": "<p>На сегодняшний день причины рака простаты до конца не установлены, однако медики указывают на факторы, которые повышают вероятность возникновения данной проблемы.</p>\r\n<p>К таким факторам относятся:</p>\r\n<ul>\r\n<li>Возраст. Основная группа риска – это мужчины в возрасте 60-70 лет.</li>\r\n<li>Гормональные изменения. За рост клеток в предстательной железе отвечает в основном мужской гормон – тестостерон. Данный гормон стимулирует рост не только обычных здоровых клеток, но также и раковых, поэтому в организме с высоким уровнем тестостерона возникновение опухоли является более вероятным.</li>\r\n<li>Генетическая предрасположенность. Согласно исследованиям американских ученых, если рак простаты встречался у кого-либо из ближайших родственников, то вероятность возникновения данной проблемы повышается в два раза.</li>\r\n<li>Питание. Мужчины, рацион питания которых по большей части состоит из животных жиров и красного мяса, больше подвержены риску возникновения рака простаты. Симптомы и течение болезни</li>\r\n</ul>",
"pathogenesis": "",
"diagnostics": "<p>Диагностика рака предстательной железы осуществляется с помощью различных методов. Основные из них это:</p>\r\n<ul>\r\n<li>Пальцевое ректальное исследование, которое производится врачом-урологом. Данный метод позволяет выявить уплотнения или узлы, которые могут свидетельствовать о ранней стадии рака простаты. Исследование уровня ПСА (простат-специфический антиген) в крови. На сегодняшний день ПСА является основным способом раннего определения злокачественной опухоли в предстательной железе.</li>\r\n<li>Трансректальное УЗИ. Позволяет установить точные параметры опухоли и определить стадию заболевания.</li>\r\n<li>Биопсия простаты. Данное исследование позволяет подтвердить или наоборот опровергнуть диагноз рака простаты. В случае если установлен положительный диагноз назначаются дополнительные обследования – компьютерная томография (КТ) и магнитно-резонансная томография (МРТ) органов таза. Данные исследования позволяют установить наличие или отсутствие метастазов, что является важным для назначения дальнейшего лечения. Лечение рака простаты Выбор метода лечения данного заболевания осуществляется в зависимости от стадии его развития, наличия метастазов и сопутствующих заболеваний, а также возраста больного. Поэтому очень важно получить точный диагноз и иметь полную картину заболевания.</li>\r\n</ul>",
"treatment": "<p class=\"title\">Лечение рака простаты может осуществляться следующим образом:</p>\r\n<ul>\r\n<li>Хирургическое вмешательство. Данный метод лечения применяется на ранних стадиях рака простаты, когда опухоль не имеет метастазов. Простата удаляется и таким образом больной полностью избавляется от рака. Лучевая терапия. Область предстательной железы и находящихся рядом лимфатических узлов облучается радиоактивными лучами. Данный вид терапии используется как на ранних стадиях, так и в случаях наличия местных метастазов в области таза, когда хирургическое лечение уже невозможно. Лучевую терапию делают путем облучения извне или при помощи радиоактивных зерен (брахитерапия), которые вводят в пораженную область простаты. Данная терапия применяется и при лечении опухоли мочевого пузыря и позволяет уменьшить опухоль и облегчить болевые ощущения. Длительность лечения – от 20 до 35 дней.</li>\r\n<li>Медикаментозное лечение – химиотерапия или гормональная терапия. Медикаментозное лечение рака простаты позволяет уменьшить рост опухоли. Химиотерапия направлена на блокирование роста и развития раковых клеток. Однако при таком лечении разрушаются и здоровые клетки, поэтому могут наблюдаться побочные эффекты – , нарушение пищеварения, повышенная и ослабление иммунитета. Гормональная терапия направлена на понижение уровня тестостерона, что способствует замедлению развития опухоли или ее уменьшению.</li>\r\n<li>Криотерапия. Опухоль разрушается посредством жидкого азота. Данный вид лечения применим при небольших опухолях.</li>\r\n<li>Радиохирургия. Такое лечение рака простаты позволяет бороться с опухолями в труднодоступных местах. Опухоль обрабатывается ионизирующими лучами большой точности, при этом окружающие опухоль здоровые клетки остаются нетронутыми. Такая методология применяется и при лечении опухоли мочевого пузыря. Продолжительность лечения составляет 3-5 дней.</li>\r\n<li>Биологическая терапия или иммунотерапия. Данную методику используют главным образом в качестве дополнительной к основному виду лечения. Иммунотерапия основывается на использовании препаратов, которые активизируют иммунную систему, вследствие чего сам организм начинает бороться с раковыми клетками. В качестве вакцины в организм вводятся ослабленные раковые клетки. Иммунная система распознает их как чужеродные и таким образом начинает их уничтожать.</li>\r\n<li>Высокоинтенсивная сфокусированная ультразвуковая абляция (HIFU). С помощью интенсивного ультразвука ткани разогреваются, что приводит к разрушению опухолевых клеток. Такое лечение рака простаты позволяет осуществлять лечение рака простаты на различных стадиях, при этом побочные эффекты () являются минимальными.</li>\r\n</ul>",
"prevention": "<p>Профилактика рака простаты (да и остальных злокачественных опухолей) заключается в том, чтобы избежать, по возможности, факторы риска и увеличить долю профилактических факторов.</p>\r\n<p>Среди мер профилактики рака простаты, которые мы можем указать на сегодняшний день, это:</p>\r\n<ul>\r\n<li>Диета – при этом особое значение придается овощам и фруктам (томаты, капуста, брокколи, соя, виноград и другие) и ограничению продуктов, содержащих животные жиры и кальций. Кроме того, ученые заметили, что заболеваемость раком простаты в мире распределяется неравномерно. Например, отмечено, что в Японии довольно низкая заболеваемость в Японии. Считается, что это связано с тем, что японцы используют в рационе много продуктов растительного происхождения, особенно сои. В ней содержатся фитоэстрогены, которые по составу близки к женским половым гормонам. Эти веществ снижают содержание мужских гормонов в организме. При этом мужские качества организм не утрачивает, но вероятность возникновения рака простаты существенно снижается. Большую роль в профилактике рака предстательной железы играют каротиноиды и альфа-токоферол (бета-каротин и витамин Е). Они содержатся в основном в продуктах растительного происхождения (овощах и фруктах).</li>\r\n<li>Образ жизни – при этом стоит ограничить курение табака, злоупотребление алкоголя и повысить уровень физической активности. Физические упражнения позволяют снизить избыточный вес, который, как считается, может быть фактором риска рака простаты.</li>\r\n</ul>\r\n<p> </p>\r\n<p>К сожалению, каких-либо препаратов, постоянный прием которых помог бы снизить риск развития рака простаты, не существует.</p>\r\n<p>Физическая активность может снизить риск рака простаты</p>\r\n<p>Исследователи отмечают, что работа, связанная с постоянным физическим трудом, может снижать вероятность развития рака предстательной железы.</p>",
"clinical_picture": "<p>Рак предстательной железы может проявляться учащенным мочеиспусканием, болями в промежности, кровью в моче и в сперме. Но может не отмечаться ни одного из этих симптомов. И тогда первым проявлением заболевания станут признаки, которые характерны для метастазов: боль в костях (таз, бедро, позвоночник) и переломы, боль в груди.</p>\r\n<p>В далеко зашедших случаях может развиться острая , а так же симптомы раковой интоксикации: человек резко худеет, слабеет, его кожа становится очень бледной с землистым оттенком.</p>\r\n<p>Более редкие симптомы рака простаты — или эрекции (рак затронул нервы, управляющие эрекцией), уменьшение объема спермы во время семяизвержения (опухоль блокирует эякуляторный канал).</p>",
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"code": "C62",
"name": "Рак яичка",
"icd_name": "Рак яичка",
"gender": 1,
"age_min": 15,
"age_max": 40,
"cause": [
"0",
"3"
],
"periodicity": 0,
"slug": "c62_rak_yaichka",
"lead": "злокачественное поражение тестикул – половых желез у мужчин.",
"description": "<p>Рак яичка — это злокачественная опухоль, развивающаяся из тканей яичек (мужских половых желез, расположенных в мошонке). Чаще встречается в возрасте от 15 до 40 лет, хотя возникновение опухоли возможно в любом возрасте, включая младенцев и пожилых людей. Выявлено три возрастных пика, связанных с возникновением рака яичка: у мальчиков до 10 лет, молодых мужчин от 20 до 40 лет и пожилых людей старше 60 лет.</p>",
"etiology": "<p align=\"justify\">Выявлено три возрастных пика, связанных с возникновением рака яичка: у мальчиков до 10 лет, молодых мужчин от 20 до 40 лет и пожилых людей старше 60 лет.</p>\r\n<p align=\"justify\">У детей рак яичка в 90% случаев развивается на фоне малигнизации эмбриональной доброкачественной тератомы. В более старшем возрасте факторами, провоцирующими развитие рака яичка, могут стать травмы мошонки, эндокринные заболевания (гипогонадизм, гинекомастия, бесплодие), радиационное излучение и др. Риск возникновения рака яичка возрастает при синдроме Клайнфельтера.</p>\r\n<p align=\"justify\">Наиболее часто рак яичка выявляется у пациентов с крипторхизмом – неопущением желез в мошонку. Различные формы крипторхизма увеличивают риск возникновения рака в неопустившемся яичке в 10 раз. При одностороннем поражении яичка вероятность возникновения опухоли контралатеральной железы также велика.</p>\r\n<p align=\"justify\">Шансы на развитие рака яичка выше у мужчин, чьи родственники первой степени (брат, отец) имели аналогичное заболевание. Рак яичка в 5 раз чаще встречается у европейцев, особенно жителей Германии и Скандинавии; реже – в азиатских и африканских странах.</p>",
"pathogenesis": "",
"diagnostics": "<ul class=\"list list-description\">\r\n<li>Анализ анамнеза заболевания и жалоб (когда появились боли, чувство тяжести в мошонке, обнаружились образования в яичке при прощупывании, увеличилось ли оно в размерах и т.д.).</li>\r\n<li>Анализ анамнеза жизни (перенесенные заболевания, оперативные вмешательства, травмы).</li>\r\n<li>Выявление наследственного фактора (были ли случаи рака яичка у близких родственников и т.д.).</li>\r\n<li>Осмотр, пальпация (прощупывание) мошонки, живота, лимфоузлов.</li>\r\n<li>УЗИ (ультразвуковое исследование) мошонки – позволяет получать изображение внутренних органов и оценивать наличие каких-либо изменений).</li>\r\n<li>Диафаноскопия — просвечивание мошонки светоисточником</li>\r\n<li>Определение в крови уровня b-ХГЧ (бета-ХГЧ, хорионический гонадотропин человека, у мужчин синтезируется опухолями), АФП (альфа-фетопротеин, значительное его повышение у мужчин указывает на наличие опухоли) и ЛДГ (лактатдегидрогеназа, фермент, участвующий в процессе окисления глюкозы и образовании молочной кислоты, накапливается в тканях организма при развитии опухоли).</li>\r\n<li>Рентгенологические исследования грудной клетки.</li>\r\n<li>МРТ (магнитно-резонансная томография, метод получения диагностических изображений, основанный на использовании физического явления ядерно-магнитного резонанса, он безопасен для организма).</li>\r\n<li> КТ (компьютерная томография, вид рентгеновского обследования, позволяющий получить на компьютере послойное изображение органов) проводятся для выявления метастазов (вторичные очаги роста опухоли, возникающие в близлежащих и удаленных органах, лимфоузлах).</li>\r\n<li>Биопсия (исследование кусочка тканей под микроскопом) тканей яичка (после операции по его удалению) – подтверждение диагноза.</li>\r\n</ul>",
"treatment": "<p align=\"justify\">Возможность органосохраняющей операции при раке яичка рассматривается при двусторонней опухоли или поражении единственной железы. После резекции яичка всем пациентам показано проведение адъювантной лучевой терапии.</p>\r\n<p align=\"justify\">Стандартом хирургического лечения рака яичка служит орхиэктомия, при необходимости с забрюшинной лимфаденэктомией. Удаление семиномных опухолей Т1-Т2 стадий дополняется лучевой терапией; при стадиях семиномы Т3-Т4, а также при несеминомном раке яичка требуется назначение системной химиотерапии. В случае двухсторонней орхфуникулэктомии или низкого уровня тестостерона пациентам назначается гормонозаместительная терапия.</p>\r\n<p align=\"justify\">Комплексное лечение рака яичка (орхиэктомия, радиотерапия, химиотерапия) могут привести к временному или длительному бесплодию и импотенции. Поэтому пациентам фертильного возраста перед лечением рака яичка рекомендуется обследование у андролога с оценкой уровня гормонов (тестостерона, ЛГ, ФСГ) и спермограммы. При намерении в дальнейшем иметь детей до начала лечения мужчина может прибегнуть к криоконсервации спермы.</p>",
"prevention": "<p>Профилактика рака яичка заключается в своевременном устранении крипторхизма, предупреждении травм мошонки, исключении облучения гениталий. Своевременному выявлению рака яичка способствует регулярное самообследование и раннее обращение к урологу-андрологу при обнаружении каких-либо изменений.</p>",
"clinical_picture": "<p>Чистая семинома протекает менее злокачественно по сравнению с другими формами опухолей яичка. Метастазы дает несколько позже, по лимфатической системе. Опухоль гормонально не активная.<br />Эмбриональный рак и тератоидная опухоль яичка отличаются более злокачественным течением, метастазы появляются рано, распространяясь как по лимфатической, так и по кровеносной системам. Опухоль гормонально активна.<br />Хорионэпителиома — наиболее злокачественная форма опухолей яичка. Метастазирует рано по кровеносной системе в легкие, печень, мозг и другие органы; метастазы могут образоваться при пальпаторно неопределяемой первичной опухоли. Опухолевая ткань вырабатывает гонадотропный гормон.<br />Интерстициальноклеточные опухоли яичка у взрослых вызывают гинекомастию и другие признаки феминизации, у детей — раннее половое развитие.<br />Для опухолей яичка характерна скудная симптоматика или начальное бессимптомное течение, вследствие чего почти в половине случаев больные обращаются к врачу с выраженными метастазами. Вначале отмечается незначительное увеличение яичка или <a title=\"Перейти на страницу симптома Отек тканей\" href=\"/symptom/otek_tkaney/\">уплотнение</a> в нем, появляется чувство тяжести или легкая болезненность в яичке. По мере увеличения яичка болезненные ощущения могут увеличиваться. Сильные боли в яичке могут зависеть от кровоизлияния, некроза или инфаркта опухоли. При поражении неопустившегося яичка прощупывается опухоль в подвздошной области или в паху. С развитием метастазов в забрюшинных лимфатических узлах появляются боли в пояснице, запоры, динамическая непроходимость, отеки нижних конечностей и др. В дальнейшем метастазы появляются в лимфатических узлах подвздошных, левой надключичной области, средостения, в печени, легких.</p>",
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"lead": "злокачественное поражение половых желез у мужчин",
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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Выявлено три возрастных пика, связанных с возникновением рака яичка: у мальчиков до 10 лет, молодых мужчин от 20 до 40 лет и пожилых людей старше 60 лет. У детей патология в 90% случаев развивается на фоне малигнизации эмбриональной доброкачественной тератомы. В более старшем возрасте факторами, провоцирующими развитие новообразования, могут стать травмы мошонки, эндокринные заболевания (гипогонадизм, гинекомастия, бесплодие), радиационное излучение и др. Риск возникновения неоплазии возрастает при синдроме Клайнфельтера.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее часто болезнь выявляется у пациентов с крипторхизмом – неопущением желез в мошонку. Различные формы крипторхизма увеличивают риск возникновения рака в неопустившемся яичке в 10 раз. При одностороннем поражении яичка вероятность возникновения опухоли контралатеральной железы также велика. Вероятность развития рака выше у мужчин, чьи родственники первой степени (брат, отец) имели аналогичное заболевание.</span></p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Окончательная причина возникновения рака яичка до сих пор не установлена, но прослеживается ряд факторов, наличие которых существенно повышает риск развития заболевания.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Выделяют три группы факторов риска: перинатальные (связанные с внутриутробным развитием плода), постпубертатные (относящиеся к периоду развития человека после завершения полового созревания) и генетические.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Перинатальные факторы: установлено, что эстрогены и эстрогеноподобные вещества могут оказывать влияние на внутриутробное формирование гонад у плода. Женские половые гормоны способны индуцировать возникновение тетраплоидии герминогенных клеток (редкий вариант хромосомных аномалий, при котором увеличивается полный набор хромосом зародышевых клеток). Это является одним из признаков развития у плода carcinoma in situ (предшественницы всех раков).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Генетические факторы риска: описана связь между генетическими изменениями (в гене-супрессоре опухоли PTEN) и риском возникновения опухолей половых клеток яичка.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Крипторхизм (неопущение яичка) увеличивает риск развития рака яичка в 5-10 раз. В утробе матери у плода мужского пола развитие яичек происходит в брюшной полости.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Обычно яички опускаются в полость мошонки при рождении или на первом году жизни. Если этот процесс задерживается или яички не опустились в мошонку, создаются неблагоприятные условия, способствующие развитию дегенеративных изменений. Чем глубже и дольше яичко расположено в брюшной полости, тем сильнее нарушается сперматогенная (репродуктивная) функция мужчины.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для постановки диагноза необходимо записаться на прием к андрологу или урологу. Обследование состоит из таких составляющих:</span></p>\r\n<p> </p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Осмотр, пальпация проблемных зон, опрос пациента и сбор анамнеза. </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">УЗИ. </span><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Эффективность ультразвукового исследования в этом случае очень высока. </span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">МРТ либо КТ. </span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Остеосцинтиграфия — необходима для выявления метастазов. </span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Анализы крови на онкомаркеры. </span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Биопсия через паховый доступ.</span></li>\r\n</ul>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Возможность органосохраняющей операции рассматривается при двусторонней опухоли или поражении единственной железы. После резекции яичка всем пациентам показано проведение адъювантной лучевой терапии. Стандартом хирургического лечения патологии служит орхиэктомия, при необходимости с забрюшинной лимфаденэктомией. Удаление семиномных опухолей Т1-Т2 стадий дополняется лучевой терапией; при стадиях семиномы Т3-Т4, а также при несеминомном раке требуется назначение системной химиотерапии. В случае двухсторонней орхифуникулэктомии или низкого уровня тестостерона пациентам назначается гормонозаместительная терапия.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Комплексное лечение (орхиэктомия, радиотерапия, химиотерапия) могут привести к временному или длительному бесплодию и импотенции. Поэтому пациентам фертильного возраста перед началом терапии рекомендуется обследование у онкоуролога с оценкой уровня гормонов (тестостерона, ЛГ, ФСГ) и спермограммы. При намерении в дальнейшем иметь детей до начала лечения мужчина может прибегнуть к криоконсервации спермы.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Чтобы снизить риски развития рака яичка, необходимо придерживаться следующих профилактических мер:</span></p>\r\n<p> </p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Регулярно (минимум раз в месяц) проводить самообследование мошонки и яичек на предмет разных уплотнений, образований, изменений размера и т. д. При появлении любых непонятных изменений обращаться за консультацией к урологу, андрологу. </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вести здоровый образ жизни: отказаться от курения, алкоголя, достаточно времени проводить в движении, питаться здоровой пищей. </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Исключить перегрев мошонки, а также ношение слишком тесной натирающей одежды. </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Избегать различных травм половых органов. </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если травма все же произошла, обязательно показаться андрологу.</span></li>\r\n</ul>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Первые признаки рака яичка проявляются не сразу. На ранних стадиях течение болезни обычно бессимптомное, лишь иногда появляется ощущение тяжести, наблюдаются изменения размеров яичка либо мошонки. Это уже повод немедленно обратиться к урологу и пройти обследование.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">По мере развития заболевания могут появляться такие симптомы и признаки рака яичек (по нарастающей):</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">болевые ощущения в мошонке; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">возникновение уплотнения, которое можно прощупать самостоятельно; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">изменение консистенции яичка (если сравнивать с другим) — пациент тоже может ощутить это сам; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">болевые ощущения в спине — с этого признака и дальше говорится о симптомах, свойственных течению болезни при метастазировании; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">отечность нижних конечностей; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">проблемы с мочеиспусканием, в работе почек; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">одышка и кашель при поражении легких; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">увеличение надключичных лимфатических узлов.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если вовремя не начать лечение рака яичка, метастазы будут распространяться очень быстро, подрывая здоровье мужчины.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Иногда случается, что симптомы рака яичка сопровождаются дополнительными изменениями на фоне сильных гормональных нарушений. В таком случае выделяют еще ряд признаков:</span></p>\r\n<p> </p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">гинекомастия — то есть увеличение молочных желез у мужчины; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">эректильная дисфункция и снижение либидо у взрослых; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">частые и долгие эрекции у мальчиков — симптомом является именно длительность и частота, а не сам факт эрекции, что для мальчиков нормально; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">преждевременное увеличение полового члена, а также раннее появление волос на лобке; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">развитие костей и мышц, которое опережает возраст.</span></li>\r\n</ul>",
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"code": "C63.9",
"name": "Рак мужских половых органов неуточненной локализации",
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"standard_type": 3,
"danger": 1,
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"parent": 7962,
"block_rubric": 29,
"standards": []
}
]
}
