Acute epididymitis
Summary/Definition
The appendage of the testicle is an organ that is located behind the testes and serves as a place for sperm maturation. Epididymitis is a disease in which there is an inflammatory process in the appendage of the testicle. Basically, inflammation of the epididymis is caused by an infection that spreads ascending from the lower urinary tract. Sexually active men under the age of 35 may become infected with sexually transmitted bacteria, such as chlamydia or Gonococcus. This is the main cause of the disease. In people over 35 years of age, the most common cause is bacteria from the intestinal group, for example, E. coli. In regions where tuberculosis is widespread, for example, in Korea, the disease can be caused by tuberculosis of the urinary tract. Epididymitis, which in some cases manifests itself in children and adolescents, may be caused by a congenital anomaly in which the ureter opens into the posterior urethra or seminal vesicle.
Symptoms
Symptoms of epididymitis include pain and swelling of the testicles and testicular appendage, fever, chills, excessive sweating, vomiting and diarrhea. The pain is felt inside the scrotum and in cases of severe course of the disease can spread to the abdomen and sides, which is accompanied by difficulties when walking. In some cases, with the development of purulent epididymitis, self-rupture may occur. It should be noted that with epididymitis caused by tuberculosis, pain may be absent.
Diagnostics
To diagnose epididymitis, a detailed study of the patient’s medical history and symptoms, as well as a physical examination, is carried out. During a physical examination, the doctor checks the condition of the testicles and appendages for signs of inflammation. A blood test is used to identify signs of inflammation and its possible causes, and a urine test helps to determine the presence of inflammation and its source. Urine culture is carried out in order to identify bacteria that cause inflammation. Ultrasound examination of the scrotum is used to assess the size, shape and structure of the testicles and appendages of the testicle, as well as to search for signs of inflammation. X-ray examination of the upper urinary tract can help to identify the cause of inflammation.
Treatment and course of the disease
Treatment of epididymitis includes drug therapy with the use of antibiotics and non-drug methods such as shell alvulotomy. The most common method of treating epididymitis is the use of antibiotics to destroy the bacteria that caused inflammation. The course of antibiotics usually lasts from 7 to 10 days. In the case of significant swelling of the epididymis with non-drug treatment, it may be necessary to perform an alveolotomy to reduce it. If the accumulated pus cannot come out naturally, drainage surgery may be required.
Complications
In acute epididymitis, a significant part of the testicles is inflamed, which leads to epididymoorchitis. In case of insufficient treatment of acute epididymitis, it can become chronic, and pus can form in the appendage of the testicle. In rare cases, bilateral epididymitis can lead to infertility.
