Inflammation of the appendages of men - acute and chronic epididymitis

August 18, 2013

 inflammation of the men
 Inflammation of the men is not uncommon. Just as in women, is a disease of males is a result of the introduction of infection and reduce the body's defenses - immunity. Epididymitis contributes to the development of a number of predisposing factors.

 Inflammation of the appendages of men - acute and chronic epididymitis

The structure of the epididymis in men

The egg is a pair of male sex glands that produce sperm and male hormones. The testicles are located in the scrotum, where they hung on the spermatic cords, consisting of the vas deferens, blood and lymph vessels and nerves.

The upper pole and the trailing edge of the testicle is adjacent epididymis, which distinguish the head, body and tail. Inside the epididymis is a tortuous duct, which fall short 12-18 efferent tubules of the testis. Duct of the epididymis passes into the vas deferens, which combines with the excretory duct of the seminal hillocks forms ejaculatory duct empties into the urethra.

 Inflammation of the appendages of men - acute and chronic epididymitis

Inflammation of the appendages of men - Causes

Inflammation of the epididymis may be caused by specific and nonspecific microflora. The nonspecific epididymitis caused by pathogenic and opportunistic pathogenic microflora that lives in the mucous membranes of the urethra (urethritis). At the same infectious agent enters the epididymis through the vas deferens or blood or lymph. The nonspecific epididymitis rarely occurs in isolation. Usually in the inflammatory process involved as the urethra, prostate and seminal vesicles.

Germs get a chance to get to the epididymis only with a decrease in immunity. The reason for the temporary reduction of immunity can be a number of factors, which are called the factors predisposing to the development of epididymitis. These include: hypothermia, scrotal trauma, sexual excesses, masturbation, interrupted sex and so on. Sometimes nonspecific epididymitis occur as a complication of a variety of urological manipulation (eg, cystoscopy).

Specific (having the identifying characteristics of the course) epididymitis is most often caused by syphilis, gonorrhea, tuberculosis and brucellosis.

Often inflammation of the epididymis young men occurs as a complication of sexually transmitted diseases (STDs) such as gonorrhea Gonorrhea - self-ruled  Gonorrhea - self-ruled
   and chlamydia. Do homosexuals and bisexuals who have anal sex, the most common cause of epididymitis are Escherichia coli and Haemophilus influenzae. Children and elderly patients with infectious agents often are representatives of conditionally pathogenic urethra. The nonspecific epididymitis can be acute or chronic.

 Inflammation of the appendages of men - acute and chronic epididymitis

Symptoms of acute nonspecific epididymitis

Acute inflammation of the epididymis begins suddenly, with a rise in temperature to high numbers, chills, malaise, severe pain in the scrotum and groin, gave outwards. In the region of the testis can be palpated enlarged and painful appendage of the scrotal skin which reddened and swollen.

With long-term course of the disease the inflammatory process may spread to the testicle. In this half of the scrotum is concerned reddened, warm, swelling, and the border between the appendage and the egg disappears. It can be painful and spermatic cord. If you lift the scrotum above the pubic area, the pain can be reduced.

Acute epididymitis can be complicated by nonspecific abscess eggs. A sign of such complications are increasing body temperature, chills, malaise. Another complication is acute epididymitis hard to be necrosis (death of) eggs because of a violation of its blood supply.

 Inflammation of the appendages of men - acute and chronic epididymitis

Symptoms of chronic nonspecific epididymitis

Chronic inflammation of the epididymis develops, usually in untreated or undertreated acute inflammatory process. But sometimes there is a primary and chronic nonspecific epididymitis.

Chronic inflammation of the epididymis appears minor pain in the scrotum (sometimes non-existent) and the increase in the epididymis. During the acute pain in the epididymis may increase but rarely significant. Appendage while painless, dense and clearly distinguished from the testicle. The skin over the inflamed scrotum appendage is not changed. The general condition of the patient with acute exacerbation of chronic epididymitis is usually not affected, temperature or does not rise at all, or is low grade.

In chronic inflammation of the appendages of men symptoms may be entirely absent, that is not to say complete absence of inflammation.

 Inflammation of the appendages of men - acute and chronic epididymitis

Inflammation of the epididymis - specific epididymitis

Various specific epididymitis different characteristic symptoms of the disease and the characteristics of its flow.

Gonorrheal epididymitis usually develops on the background of gonococcal urethritis and is its complications. Adrift and the main symptoms of the disease gonoreyny epididymitis is not very different from the non-specific.

Syphilitic epididymitis is a complication of a tertiary (gummy) syphilis eggs. Thus gummas (small bumps) are subjected to decay or melt and merge with each other and are gradually replacing testicular tissue and its appendage, which leads to a complete disruption of the function of these organs.

Brucellosis epididymitis - a complication of Brucella destruction of eggs and is often one-sided. After developing epididymitis, the boundary between the testicle and its appendages disappear. When acute course of the inflammatory process occurs, which is accompanied by swelling of the tissue. Chronic disease characterized by the development of connective tissue atrophy of testicular tissue and its appendage, the formation of granulomas characteristic of brucellosis. Brucellosis inflammation of the epididymis causes pain in the affected side of the scrotum.

Tuberculous epididymitis is often combined with tuberculosis of the kidney. In most cases, symptoms of tuberculous epididymitis reveals tuberculosis Tuberculosis - a full recovery is not guaranteed  Tuberculosis - a full recovery is not guaranteed
   other organs of the urogenital system. The defeat of the epididymis can be unilateral and bilateral. In chronic course of the disease initially affected the prostate gland, then the process moves to the epididymis. Thereafter, the process may be a long time to develop, but sometimes he still goes to the testicle. The epididymis and testis forms from the skin of the scrotum single conglomerate, tubercular abscess Abscess - why it is so dangerous ulcers?  Abscess - why it is so dangerous ulcers?
 , Fistulas from which come to the surface of the scrotum.

Meet and sharp for tuberculous epididymitis, the disease begins much like a non-specific acute epididymitis, and then after a few days the process subsides and becomes sluggish.

 Inflammation of the appendages of men - acute and chronic epididymitis

Inflammation of the epididymis - diagnostics

Diagnosis of acute nonspecific epididymitis is based primarily on the characteristic symptoms of the disease. In general, the analysis of blood of a patient with acute epididymitis can see signs of inflammation - increase the number of leukocytes, especially granular and ESR acceleration. Urinalysis often shows the presence of pus and bacteria. Of great importance is a urine culture to culture media to identify the pathogen and its sensitivity to antibiotics.

In the diagnosis of chronic nonspecific epididymitis except symptoms are important microbiological (crops on nutrient media midstream urine and swabs of the urethra) and urinary cytology, prostatic secretions, semen. In addition, studies conducted instrumental urinary organs. If chronic epididymitis occurs as a complication of chronic prostatitis Chronic prostatitis - every man should know his signs  Chronic prostatitis - every man should know his signs
 , The secret of the prostate may increase the number of inflammatory cellular elements.

Ultrasonography (USG) with transrectal (located inside the rectum) reveals in acute epididymitis expansion of the seminal vesicle with stakeholders. With the help of ultrasound can also reveal the presence of an abscess in the testis and its appendages.

Radiographic studies urinary organs also help clarify the diagnosis of the disease.

Sometimes chronic nonspecific epididymitis is difficult to distinguish from a tumor of the epididymis and testis, as well as tuberculous epididymitis. To clarify the diagnosis in this case, a biopsy of the epididymis.

 Inflammation of the appendages of men - acute and chronic epididymitis

Inflammation of the epididymis - treatment

Held antibiotic therapy based on the results of analyzes on the sensitivity of the pathogens to antibiotics. The most active against pathogens that cause infectious inflammation of the urogenital organs, showing fluoroquinolones (eg, ofloxacin), antibiotics tetracycline (doxycycline) and macrolides (clarithromycin).

Work is also symptomatic treatment of inflammatory and pain medications, wearing a jockstrap or tight swimming trunks to reduce pain in the perineum. In very severe pain or lidokainovaja held novocaine blockade of the spermatic cord.

When abscess formation and necrosis of the testis surgical treatment - an egg is removed.

Inflammation of the epididymis in men requires prompt diagnosis and appropriate treatment appointment.

Galina Romanenko

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