Epididymitis called inflammation of the epididymis, which can be an independent disease, and may accompany other inflammatory diseases of the male reproductive system. Epididymitis occurs at any age, including children. There are acute epididymitis, chronic epididymitis and acute. By the nature of the inflammation process can be serous, purulent, and infiltrative.
Epididymitis may result from ascending infection, penetrating into the body from the external genitals, descending infections when the pathogen penetrates into the epididymis from the bowel, bladder or prostate. In some cases, epididymitis is common complication of an infectious disease organism (influenza, tonsillitis, tuberculosis, etc.) Or perineal trauma, including surgery. One type of traumatic epididymitis is an inflammation of the epididymis after ligation of vas deferens caused by violation of the evacuation of sperm, and the consequent stagnation.
The agents of epididymitis in adults often are urogenital infections, they are the same infections, sexually transmitted infections (STIs or IGO): gonorrhea, chlamydia, ureaplasma, mycoplasma, trichomonas. In the case of infection by the descending is usually E. coli, Proteus, staphylococci or streptococci.
Factors contributing to the development of epididymitis are:
- The presence of diseases of the genitourinary system;
- The presence in the body of foci of chronic infection;
- Acute and chronic injury of the perineum;
- Sedentary, especially a sedentary lifestyle;
- Irregular and disorderly sexual life;
- Failure to comply with the rules of personal hygiene.
Symptoms of epididymitis
Symptoms depend on epididymitis, acute or chronic inflammation occurs. As a rule, the original disease occurs acutely, and chronic epididymitis is the result of untreated or undertreated acute epididymitis.
Symptoms of acute epididymitis: a sharp pain in the perineum, aggravated by movement, at first did not localized, and then focusing in on one side of the testicle. Scrotum by inflammation and swelling increased, there is redness, skin smoothed image. Acute epididymitis is accompanied by a rise in temperature to 38-39 ° C, fever, deterioration of general condition, headaches and muscle and joint pains. There is a positive symptom of debate: reduction in pain when lifting the scrotum. This distinguishes acute epididymitis from testicular twist in which the symptom DEBATE negative.
Symptoms of epididymitis in the chronic form is usually less pronounced, and sometimes nonexistent, appearing only during exacerbations. Chronic epididymitis proves painful testicle when walking and an increase in the seal and the epididymis, which is felt by palpation as education, tightly knit with egg and slightly painful.
The diagnosis of acute epididymitis is not difficult, and is placed on the basis of history and examination of the external genitalia. In chronic epididymitis epididymitis and escalating spend scrotal ultrasound. For the diagnosis of epididymitis it is crucial to the definition of the pathogen that caused the inflammation. To this end, spend bakposev and laboratory research content of the urethra, and urine culture. If you suspect that epididymitis caused by sexually transmitted infections, conduct all the necessary tests to determine the causative agent of urogenital infections.
Treatment of epididymitis
Treatment of epididymitis depends on the form of the disease, but it is similar to the scheme, and in fact, and in another case: antibiotic therapy to eliminate the pathogen, anti-inflammatory therapy, prevention and management of complications of inflammation.
Treatment of acute epididymitis: prescribe a course of antibiotic therapy with broad-spectrum antibiotics, the children used sulfa drugs (Bactrim). Also appointed non-hormonal anti-inflammatory and pain relievers, cold on the crotch area, bed rest with the scrotum elevated position, wearing a jockstrap when moving (or sling tight swimming trunks). It recommends a diet that excludes the consumption of spicy, greasy, fried, smoked, salty foods. When calming acute symptoms of epididymitis commence physiotherapy: warm baths herbal hot compress to the affected area, microwave, laser, magnetic therapy and others. Procedures aimed at the removal of inflammation and preventing the development of adhesions.
Treatment of chronic epididymitis is the appointment of antibacterial therapy with the specific pathogen, the use of steroidal anti-inflammatory drugs, physical therapy means the active application, resolving agents, as well as strengthening therapy (vitamin therapy, immunotherapy). In establishing the STI as the causative agent of chronic epididymitis, it is imperative the treatment of the sexual partner of the patient, as otherwise relapse is inevitable. For the period of active treatment measures must be abstinence. Treatment of chronic epididymitis requires perseverance and patience, but it certainly should be brought to a complete cure.
In case of failure of conservative treatment of epididymitis and abscess forms, or persistent chronic epididymitis flowing with constant exacerbations resort to epididymectomy - surgery to remove the epididymis.
Complications of acute epididymitis are: abscess of the epididymis, the transition to a chronic form of the disease, which is a poor outcome, because treatment of chronic epididymitis is more complicated and time-consuming. Abscess of epididymis - the development of purulent inflammation, which resulted in the appendix may be subject to melt completely. This serious complication, as the process may spread to adjacent organs. When abscess appendage requires hospitalization and emergency surgical care. An abscess is opened, the pus is removed, the wound washed with antiseptics and drain. Surgical treatment is complemented by the appointment of antibiotic therapy.
Complications of chronic epididymitis is obliteration (violation of patency as a result of adhesions) of the epididymis. Chronic epididymitis in most cases is a two-way, and the development of bilateral epididymal obstruction leads to obstructive infertility. In this case, surgery may be necessary to restore patency of the vas ways.