Epididymitis: Symptoms and Treatment


Epididymitis is an inflammation of the epididymis of an infectious or non-infectious etiology. This appendage looks like a spiral tube and is located on the posterior surface of the testicle, securing it to the vas deferens. In case the inflammatory process affects both the testicle and the appendage simultaneously, the male develops an orchoepidymitis.

Epididymitis epididymis affects men from any age group. Most often it develops in the stronger sex at the age of 20 to 40 years (during sexual activity).

In most clinical situations, testicular epididymitis is a complication of infectious diseases of bacterial and viral etiology. The reason lies in the fact that the infection can penetrate into the epididymis of the testicles with lymph or blood.

Typically, first the infection affects one testicle (developing on the right or left), but later it can hit the second one.

Reasons

The development in the male epididymitis of the epididymis can be caused by a number of reasons. Therefore, every member of the stronger sex should know them and avoid them in every possible way, so that afterwards they do not ask themselves the question «How to treat epididymitis?»


  • In more than 80% of cases, the main cause of the development of this ailment in men is a bacterial infection. In medicine, there are two large groups of epididymitis pathogens epididymitis epididymis — STI and intestinal bacteria. In men aged 20 to 40 years, the main cause of the development of pathology is precisely STI (gonorrhea, syphilis, trichomoniasis), as they lead a more active sexual life. Intestinal bacteria provoke the development of the disease in men after 40 years;
  • In some cases (very rarely) bacteria or fungi can become the cause of the disease development
  • In childhood, the cause of epididymitis is viral infections. The adherence of the testicle can become inflamed after the influenza, chickenpox, mumps, and the like;
  • taking some synthetic medications can also trigger the development of pathology. For example, often the drug epididymitis develops after a long reception of the heart drug Amiodarone;
  • injuries of testicles and scrotum. They can be different — mechanical, after the performed manipulations and surgical interventions
  • promiscuous sexual intercourse
  • severe hypothermia
  • Sexual excesses.

Classification

Epididymitis by the nature of the course of the inflammatory process is divided into nonspecific and specific.

Classification by type of agent:


  1. Viral
  2. fungal;
  3. Bacterial;
  4. Chlamydia;
  5. Mycoplasmatic.

Traumatic epididymitis can also be divided into three groups:


  • Postoperative;
  • Post-instrumental;
  • strictly traumatic.

Classification with the flow:


  1. acute;
  2. subacute;
  3. chronic;
  4. Recurrent.

Acute form

Acute epididymitis affects patients aged 15 to 30 years. Rarely occurs in the elderly. The first symptom that forces a man to seek help is the appearance of severe pain in the testicle. Pain can irradiate into the groin, the perineum and even into the sacrum. The disease proceeds swiftly. Its peak comes in a day after the first manifestations.

Gradually the swelling of the scrotum grows, the skin on it becomes red. If at this moment to test the testicle, then next to it will be palpated seal. For 4 hours, it can increase two or more times.

Symptoms:


  • enlarged lymph nodes in the inguinal area
  • increase in body temperature to high digits (39-40 degrees)
  • Insignificant discharge can be seen from the urethra
  • increased urination
  • chills;
  • nausea and vomiting occur against the background of general intoxication
  • pain in the scrotum is amplified during active movements or defecation
  • in the urine, you can notice an impurity of blood.

All the above symptoms of epididymitis become less pronounced after 2-5 days. Many representatives of the stronger sex, in view of the short period of pain and discomfort, do not rush to go to the doctor. If you do not carry out a qualified treatment of epididymitis, then the site of inflammation is formed scars. The spermathecal canal becomes impassable and this will lead to infertility. This is the most terrible complication of acute epididymitis.

Chronic form

Chronic epididymitis develops in men in the event that timely treatment of the acute form of the disease has not been carried out. In total, this process takes more than 6 months. A person may not even suspect the development of this complex pathology. If the acute epididymitis symptoms manifest immediately and reach the peak of their activity within a day, then in this case, the symptoms are almost absent. A man feels some discomfort in the testicle area only during a period of exacerbation of the disease. Externally, the scrotum does not change the shape or color.





In chronic epididymitis, the epididymis becomes more numerous (but not always), becomes denser and painful when palpated. The spermatic cord grows thicker, and the spermatic duct becomes wider in diameter.

Diagnostics

If any of the above symptoms appear, it is recommended to visit a qualified urologist immediately, in order to conduct a survey and clarify the diagnosis. Sometimes the patient will need to be hospitalized. On how early a man turned to a doctor, it depends not only the effectiveness of the treatment, but also the ability to reduce the risk of complications.

The most effective methods for diagnosing chronic and acute epididymitis:


  1. a patient interview on which the doctor will examine the main complaints of a man
  2. Inspection. At this stage, the doctor discovers external changes in the shape and color of the scrotum, palpatorically refines the localization of inflammation, probes the inguinal lymph nodes;
  3. UAC
  4. OAM
  5. Smear from the urethra
  6. Urine culture tank
  7. PCR and ELISA — provide an opportunity to identify STIs
  8. Ultrasonic dopplerography of the urogenital organs
  9. ultrasound of the scrotum organs
  10. computed tomography
  11. magnetic resonance tomography

In necessarily order, it is necessary to conduct a survey and the sexual partner of the patient, even if he does not have any symptoms.

Complications

If you timely treat epididymitis epididymis, the person completely recovers. For this purpose, he is prescribed medication (various groups of drugs), as well as physiotherapy and so on. In this case, reproductive capacity is preserved. But if the disease is not treated, it will develop into a chronic form and various complications may arise.

Possible complications:


  • the inflammatory process will spread to the testicles and other organs
  • scrotal abscess
  • testicular necrosis;
  • fistulas on the scrotum
  • sepsis
  • Fugnier gangrene
  • male infertility.

Treatment

Treatment of epididymitis of the epididymis should be only complex. First of all, the patient is prescribed medication. It will be necessary to take the following drugs:


  1. antibiotics
  2. Non-steroidal anti-inflammatory drugs
  3. resorbable drugs
  4. Vitamins.

The most effective are antibiotics, since they have a harmful effect on the bacteria that cause the development of the inflammatory process. They are appointed after taking a smear from the urethra and its inoculation (the study helps identify the main pathogen). Most often appoint Ceftriaxone, Sumamed, Azithromycin, Doxycycline, Rocefin and others. The course of treatment is 10 days. The correct dosage will be chosen by the doctor taking into account the features of the course of the disease and its complexity.

The doctor also prescribes anti-inflammatory and resolving drugs to stabilize the patient. After acute manifestations of the disease will be stopped, physiotherapeutic treatment is prescribed-UHF, diathermy, etc.

Surgical treatment is indicated to patients in the presence of complications. The operation is carried out at:


  • suppuration of the epididymis;
  • torsion of the epididymis or testis
  • testicles abscess
  • acute post-traumatic epididymitis

Epididymitis epididymis is a very dangerous and complex disease that can not be allowed to run, as it is fraught with the development of complications. At the first symptoms it is necessary to go immediately to a doctor’s appointment, to carry out diagnostics and begin treatment.