Epididymitis is an inflammation of the epididymis. Sometimes epididymitis is a complication of a common infectious disease – influenza, pneumonia, tonsillitis, or some other. But most often, epididymitis occurs with a chronic inflammatory disease of the genitourinary organs – urethritis and prostatitis. The appearance of epididymitis is often promoted by trauma to the scrotum, perineum, pelvis, as well as all those factors that contribute to stagnation of blood in the small pelvis. Most often, epididymitis is acute, but chronic inflammation of the epididymis also occurs.
A special type of epididymitis is the appearance of this disease after sterilization – ligation or removal of the vas deferens. In this case, the spermatozoa formed in the testicles do not have time to dissolve, accumulate in the appendages and cause inflammation.
Symptoms of epididymitis
The disease begins acutely with the appearance of pain in one half of the scrotum and its increase. The pain can spread to the groin, perineum, sometimes even to the sacrum and lower back, sharply aggravated by movement. The scrotum on the side of the lesion increases, its skin turns red, loses its folds due to edema. At the same time, the patient’s body temperature rises to 38–39 ° C, general symptoms of an inflammatory disease appear – weakness, headache, loss of appetite, etc.
The epididymis increases, becomes dense, sharply painful when touched.
What happens if not treated
If untreated, after a few days, the inflammatory process in the epididymis can lead to its suppuration. At the same time, the patient’s condition deteriorates sharply, the body temperature increases, the skin of the scrotum becomes glossy, sharply painful when touched. Another complication of epididymitis is the transition of inflammation to the testicle, the development of acute orchitis. With a long course of the inflammatory process, connective tissue may grow in its finale, which will lead to obstruction of the epididymis for spermatozoa. With bilateral epididymitis, this will cause an obstructive form of infertility.
Treatment of acute epididymitis
In mild forms of epididymitis, patients are treated at home, hospitalization is carried out only when there is a possibility of developing complications of the disease. A patient with epididymitis must comply with strict bed rest. To ensure the immobility of the scrotum, it is given a fixed elevated position (with the help of a folded towel). For the period of treatment, it is necessary to follow a diet that excludes spicy and fried foods from consumption. During acute inflammation, local application of cold is necessary – a cold compress on the scrotum or ice (duration of the session is 1-2 hours, a break of at least 30 minutes).
Be sure to treat the disease that led to the development of epididymitis. Antibiotics, enzymes, absorbable drugs, vitamins are also prescribed. When the acute inflammatory process in the epididymis subsides, thermal procedures are applied to the scrotum, physiotherapy.
With the development of suppuration of the epididymis, an operation is performed – opening and draining the abscess, in severe cases – removal of the epididymis.
Symptoms of chronic epididymitis
Chronic epididymitis often develops with specific inflammatory diseases (syphilis, tuberculosis) or after male sterilization. It is manifested by constant or intermittent pain in the testicle, especially when walking. The pain may radiate to the groin, sacrum, lower back. Body temperature regularly rises to 37°C. The epididymis is dense to the touch, painful, with areas of compaction.
Chronic epididymitis is more likely than acute epididymitis to be bilateral and has a much greater chance of leading to bilateral obliteration of the epididymis and causing an obstructive form of infertility.
Treatment of chronic epididymitis
fundamentally the same as acute, but more long-term, with a greater emphasis on local treatment, physiotherapy procedures. With the failure of conservative therapy and the development of complications, they resort to epididemictomy – the surgical removal of the epididymis.
Which doctor treats epididymitis?
As a rule, patients who have epididymitis are treated by a urologist. If it is necessary to perform an operation, surgeons specializing in operative urology are involved. To determine the role of provoking factors in the development of the disease and assess the general condition of the patient, consultations are held with a doctor, therapist, and oncologist.
Treatment tactics
Therapeutic tactics in the treatment of epididymitis is aimed at eliminating the causes of the disease, the inflammatory process, pathological symptoms and preventing complications. The physician decides how to treat the patient’s epididymitis after carefully reviewing the results of the diagnostic examination.
Prevention of epididymitis
Prevention consists in the treatment of chronic inflammatory diseases of the genitourinary organs, primarily chronic urethritis and prostatitis. In other cases, you just need to carefully listen to your feelings, especially if you happen to suffer a common infectious disease (acute pneumonia, tonsillitis) or get injured in the scrotum, and at the slightest suspicion of epididymitis, immediately seek help from a urologist.
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