Epididymite

Epididymite call an epididymis inflammation which can be an independent disease, and can accompany other inflammatory diseases of a male reproductive system. The epididymite meets at any age including at children. Distinguish an acute epididymite, a chronic epididymite and aggravated. On character of an inflammation process can be serous, purulent and infiltrative.

Epididymite reasons

The epididymite can result from the ascending infection getting into an organism from external genitals, the descending infection when the activator gets into an epididymis from intestines, a bladder or a prostate. In certain cases the epididymite is a complication of the general infectious disease of an organism (flu, tonsillitis, tuberculosis and so forth) or crotch injuries including the operating room. One of types of a traumatic epididymite is the inflammation of epididymes after bandaging of seed channels caused by disturbance of evacuation of spermatozoa, and the stagnation caused by it.

Causative agents of an epididymite at adults most often are urogenital infections, they are infections, sexually transmitted (UGI or STD): gonokokk, chlamydias, ureaplasmas, mycoplasmas, trichomonads. In case of hit of an infection in the descending way it is usually colibacillus, proteas, staphylococcus or streptococci.

The factors promoting development of an epididymite are:

• Overcooling;
• Existence of diseases of urinogenital system;
• Existence in an organism of the centers of persistent infection;
• Acute and chronic injuries of a crotch;
• Slow-moving, especially sedentary life;
• Irregular and chaotic sexual life;
• Non-compliance with rules of personal hygiene.

Epididymite symptoms

Symptoms of an epididymite depend on that, in an acute or chronic form the inflammation proceeds. As a rule, originally the disease arises sharply, and the chronic epididymite is result of not treated or undertreated acute epididymite.

Symptoms of an epididymite of an acute form: the sharp crotch pain amplifying at the movement, which in the beginning is not localized, then concentrating in the field of a small egg on one party. The scrotum from an inflammation is edematous and increased, there is a reddening, the skin drawing is maleficiated. The acute epididymite is followed by rise in temperature to 38-39 °C, fever, deterioration in the general state, head and muscular and joint pains. The positive symptom of Pren is noted: reduction of pain when raising a scrotum. It distinguishes an acute epididymite from a retwist of a small egg at which Pren's symptom negative.

Epididymite symptoms in a chronic form are usually less expressed, and sometimes can be absent in general, being shown only during aggravations. The chronic epididymite proves morbidity of a small egg when walking and increase and consolidation of an epididymis which at a palpation is felt as the education which is densely soldered to a small egg and poorly painful.

Diagnosis of an epididymite

The diagnosis of an acute epididymite does not cause difficulties, and is put on the basis of given the anamnesis and survey of external generative organs. At the chronic epididymite and an epididymite which aggravated carry out ultrasonography of a scrotum. For diagnosis of an epididymite crucial importance has definition of the activator which caused an inflammation. For this purpose carry out бакпосев and a laboratory research of contents of an urethra, and also бакпосев urine. At suspicion of the epididymite caused by STD carry out all necessary tests for definition of the causative agent of an urogenital infection.

Treatment of an epididymite

Treatment of an epididymite depends on a disease form, but its scheme is similar in either case: antibacterial therapy for the purpose of elimination of the activator, antiinflammatory therapy, the prevention and elimination of complications of an inflammation.

Treatment of an epididymite acute: appoint a course of antibacterial therapy using antibiotics of a broad spectrum of activity, at children use sulfanamide drugs (Bactrimum). Also anesthetics, cold are appointed to area of a crotch, a bed rest with the raised provision of a scrotum non-hormonal antiinflammatory, at movement carrying a suspenzoriya (the supporting bandage or hard swimming trunks). The diet, the excluding consumption of spicy, greasy, fried, smoked, salty food is recommended. When subsiding acute symptoms of an epididymite start physiotherapeutic procedures: to warm trays from officinal herbs, to the warming compresses on the struck area, the microwave oven - lazero-, magnetotherapies, etc. to the procedures directed to removal an inflammation and the prevention of development of commissural process.

Treatment of a chronic epididymite consists in purpose of antibacterial therapy taking into account the revealed activator, use of steroid antiinflammatory drugs, active use of physiotherapeutic means, resorptional means, and also fortifying therapy (vitamin therapy, immunocorrection). At establishment of STD as the causative agent of a chronic epididymite, obligatory treatment of the sexual partner of the patient is necessary, otherwise the recurrence of a disease is inevitable. For carrying out active medical measures sexual abstinence is necessary. Treatment of a chronic epididymite demands persistence and patience, but it surely should be brought to full healing.

In case of failure of conservative treatment of an epididymite and development of the abscessing form, or the persistent chronic epididymite proceeding with constant aggravations resort to an epididimektomiya – operation on removal of an epididymis.

Epididymite complications

Complication of an acute epididymite are: epididymis abscess, transition of a disease to a chronic form that is a failure as treatment of a chronic epididymite more difficult and long on time. Epididymis abscess - development of a purulent inflammation as a result of which the appendage can undergo fusion completely. This terrible complication as process can be thrown on the next bodies. At abscess of an appendage hospitalization and the acute surgical management is required. Abscess is opened, pus is removed, the wound is washed out antiseptic agents and drained. surgical treatment is supplemented with purpose of a course of an antibioticotherapia.

Complication of a chronic epididymite is the obliteration (disturbance of passability as a result of commissural process) an epididymis. The chronic epididymite in most cases happens bilateral, and development of bilateral impassability of epididymes leads to obturatsionny infertility. In this case surgical recovery of passability of seminiferous ways can be required.