EpididymitisThis infection of the epididymis, the testicle's cordlike excretory duct, is one of the most common infections of the male reproductive tract. It usually affects adults and is rare before puberty. Epididymitis may spread to the testicle itself, causing orchitis; bilateral epididymitis may cause sterility.
Epididymitis usually results from pyogenic organisms, such as Enterobacteriaceae and Pseudomonas. Epididymitis can result from an existing urinary tract infection or prostatitis and reach the epididymis through the lumen of the vas deferens.
Rarely, epididymitis is secondary to a distant infection, such as pharyngitis or tuberculosis, that spreads through the lymphatics or, less commonly, the bloodstream.
Other causes include trauma, gonorrhea, syphilis, and a chlamydial infection. Trauma may reactivate a dormant infection or initiate a new one. Epididymitis is a complication of prostatectomy and may also result from chemical irritation by extravasation of urine through the vas deferens.
Signs and symptoms
The symptoms of epididymitis include:
Epididymitis can be hard to distinguish from testicular torsion, particularly in younger men. Testicular torsion means the testicle has twisted and choked off its supply of blood. Sometimes, epididymitis and testicular torsion can occur at the same time. Epididymitis is diagnosed using a number of tests, including:
The goal of treatment is to reduce pain and swelling and combat infection. Therapy must begin immediately, particularly in the patient with bilateral epididymitis, because sterility is always a threat.
During the acute phase
Treatment consists of bed rest, scrotal elevation with towel rolls or adhesive strapping, broad-spectrum antibiotics, and analgesics.
An ice bag applied to the area may reduce swelling and relieve pain. (Heat is contraindicated because it may damage germinal cells, which are viable only at or below normal body temperature.) When pain and swelling subside and allow walking, an athletic supporter may prevent pain.
Safer sexual practices, such as monogamous sex and condom use, help protect against STDs. If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor may discuss with you other ways to prevent recurrent episodes of epididymitis.
In the older patient undergoing open prostatectomy, bilateral vasectomy may be necessary to prevent epididymitis as a postoperative complication; however, antibiotic therapy alone may prevent it. When epididymitis is refractory to antibiotic therapy, epididymectomy under local anesthetic is necessary.
(c) Health-care-clinic.org All rights reserved
Disclaimer: Health-care-clinic.org website is designed for educational purposes only. It is not intended to treat, diagnose, cure, or prevent any disease. Always take the advice of professional health care for specific medical advice, diagnoses, and treatment. We will not be liable for any complications, or other medical accidents arising from the use of any information on this web site. Please note that medical information is constantly changing. Therefore some information may be out of date.