Epididymitis | MEDICH
Epididymitis

Epididymitis

Disease of the epididymis, as a rule, occurs against the background of another inflammatory disease of the male reproductive system, for example, prostatitis, vesiculitis, urethritis.

 It is an inflammation of the epididymis, which often develops on one side and is usually acute. If the testicle is involved in the process. Less commonly, the inflammatory process initially develops in the testicle (orchitis) and only then can spread to the appendage. A similar situation is usually observed with viral lesions.

Reasons

 The penetration of the infection into the appendage is possible in various ways: with blood from other foci of infection, from the urethra in the presence of urethritis and / or cystitis. It is also possible autoimmune damage to the testicle and epididymis.

Risk factors:

  • infectious processes in the lower urinary tract: urethritis, cystitis, prostatitis;
  • sexually transmitted infections: gonococcus, chlamydia, trichomonas;
  • the presence of infectious diseases in other organs (tonsillitis, pneumonia …);
  • systemic infectious diseases (tuberculosis, syphilis);
  • injuries to the scrotum;
  • viral diseases (epidemic parotitis);
  • prolonged presence of the catheter in the urethra;
  • instrumental methods of research (urethroscopy, urethrocystocopy);
  • reduced immunological protection of the body.

 Symptoms

 Based on the clinical course emit:

  1. Acute;
  2. Chronic.

Symptoms of orchitis and epididymitis have a similar picture. The acute process usually begins suddenly with a rapidly increase and the appearance of sharp pains on the affected side, an increase in body temperature to 38-40 C, chills. Inflammation and swelling spread to the shell of the testicle and scrotum, causing the skin to stretch, losing folds, becoming red. Reactive dropsy (hydrocele) may occur. Sometimes pains radiate (give) to the groin, lumbar region, less often to the sacrum. Pain increases sharply when moving, and therefore, patients are forced to stay in bed. The symptoms of chronic one and orchitis do not differ from those in acute inflammation, but the intensity of the manifestations is much less.

Complications of inflammation:

  1. An abscess of the appendage;
  2. Male infertility.

 Diagnostics

 Diagnosis is not usually  difficult and is based on data from a survey, examination, ultrasound of the scrotum organs. When orchepididymitis it is obligatory to exclude testicular torsion (spermatic cord). It is important to remember that raising the scrotum with epididymitis and orchitis reduces pain symptoms, whereas with torsion, such manipulation leads to increased pain. An isolated increase should suggest the presence of a tumor or a brucellosis lesion. It is also necessary to exclude the possible presence of a strangulated inguinal hernia, as well as suppuration of the cyst of the spermatic cord.

Treatment

 When treating epididymitis and / or orchitis, the following rules should be followed:

  • bed rest;
  • elevated position of the scrotum;
  • after subsiding of the inflammatory phenomena, thermal procedures are prescribed (semi-alcohol compress, UHF-therapy);
  • acute inflammation of the epididymis and testicles are indications for hospitalization.

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