Epididymitis acute and chronic - Causes, symptoms and treatment. MF.

Epididymitis is an acute or chronic inflammation of the epididymis. In order to better understand the essence of the disease with epididymitis, it is necessary to determine what the given anatomical organ is. The testicle appendage is part of the vas deferens, through which the sperm is transported from the testicle to the outside.

Anatomy of epididymitis

Causes of epididymitis

There are several main reasons that can lead to inflammation in the appendages of the testes. Firstly, it is an infection of the urethra, which can be caused by fungi, viruses and bacteria of very different origin. Most often, the primary process is localized in the testicle, which is anatomically located in the neighborhood, although there are cases when infection occurs even from the urethra or bladder.

The next reason is the use of the urethra catheter. It is used very often during preparation for surgery, as well as with a complicated outflow of urine from the bladder. Quite often, medical personnel do not adhere to the necessary sterility and, together with a catheter, the hospital flora enters the bladder cavity, which later spreads to the epididymis.

Diseases such as urethritis and prostatitis, during the period of exacerbation, can spread to the scrotum, where the testicles or their appendages are affected, causing, strictly speaking, acute orchitis or epididymitis.

Obstructed urination, in particular because of prostate adenoma, can lead to the development of epididymitis. In such a situation, direct urine becomes urine, which, delayed for a long time in the bladder, can reverse the current into the epididymis.

All of these causes most often become factors that cause acute epididymitis. As for the chronic form of the disease, it can occur against a background of repeated epididymitis or poor treatment of acute pathology.

Symptoms of epididymitis

The first symptom that can indicate a disease with epididymitis is the presence of blood in the urine. Although, only on this basis, you can not put such a diagnosis. Still, at a minimum, the patient should be concerned about pain in the lower abdomen, discomfort during urination or defecation, as well as febrile condition and painful swelling of the scrotum. A complex of similar symptoms suggests that the patient has acute epididymitis. In this situation, an urgent appeal to the urologist is necessary, otherwise the disease can have quite serious consequences.

As for the chronic form of epididymitis, it proceeds much milder. The patient may be disturbed by minor pain during the act of ejaculation, as well as uninvolved discharge from the opening of the urethra that are purulent or bloody in nature. Minor clinical symptoms do not mean that chronic epididymitis is less dangerous. If there are minimal symptoms, you should also contact the urologist immediately.

Diagnosis of epididymitis

Despite the abundance of clinical symptoms, it is quite difficult to diagnose epididymitis. The fact is that almost all the signs of this disease are repeated in orchitis. Therefore, it is extremely important to differentiate these two pathologies. In addition, orchitis and epidemitis may occur in parallel, this disease is called orhoepidymitis.

After going to the hospital, the patient will have to pass at least a general blood test. In his results, you can see an increase in the number of white blood cells, which indicates the presence of inflammation in the body.

In order to somehow localize the diagnosis, you will have to use ultrasound in Doppler mode, which allows you to determine the blood flow in the affected organ.

Ultrasound in Doppler mode( red indicates inflamed tissue)

In addition, urine culture is widely used for microflora and tests for chlamydia. This allows you to exclude or confirm infectious damage to the genitourinary system and to deal directly with the treatment of the revealed pathology.

Treatment of epididymitis

The main group of drugs that are used to treat acute and chronic epididymitis are antibiotics. In this case, as a rule, antibiotics from the group of fluoroquinolones are used. They have a very wide spectrum of action and, in comparison with other drugs, are not that expensive. These medications can only be used if your diagnosis is officially confirmed by the urologist.

In addition to antibiotics, non-steroidal anti-inflammatory drugs are used for epididymitis, of which paracetamol and ibuprofen are bright representatives. These drugs not only lower body temperature, but also have strong anti-inflammatory, analgesic and immunomodulatory effects.

In addition, with chronic epididymitis, regional physiotherapy is used. It has a positive effect on the healing process and restoration of the function of the affected organ.

Features of diet and lifestyle with epididymis

During the disease, it is very important to adhere to a special regimen, which can significantly reduce the time spent in the hospital or spent on outpatient treatment. In the early period of the disease, when a fever is expressed, it is recommended to observe only bed rest. After normalization of body temperature, the regime expands, but not further than the ward, since even the slightest hypothermia can lead to a repeated exacerbation of the disease. In addition, a daily toilet of external genitalia is recommended with warm water.

Rehabilitation after illness

As a rule, after recovery in the body there is still a pathogen that can be activated at any time. Therefore, after recovery, it is extremely important to strengthen your own immunity as much as possible. To do this, it is recommended to take complexes of vitamins and minerals, attend physiotherapy sessions and at least once for two years to undergo a course of rehabilitation with healing mud in one of the sanatoriums.

Treatment of epidemitis with folk remedies

Whatever herbs are not used during epididymitis, they can not exterminate germs and an inflammatory focus from the body. Therefore, the use of antibiotics is simply an obligatory procedure during the treatment of acute and chronic epididymitis. Diuretics based on herbs can be used exclusively for the chronic form of the disease in the period between acute inflammations, which inhibits the return flow of urine and prevents infection in the appendages of the testes.

Complications of epididymitis

If we talk about chronic epididymitis as such, it is already a complication of the acute form of the disease.

In addition, due to acute inflammation of the epididymis, a focus of purulent inflammation in the scrotum may be formed, which is called an abscess. In such a situation, one can not do with antibiotics alone. Here we need radical surgical measures, the consequence of which can even be the removal of the testicle. Therefore, the whole process of treatment of epididymitis is aimed specifically at preventing this complication.

If the abscess is not opened in time, then the skin can form on the skin of the scrotum, leading to the focus of that purulent inflammation. In this situation, it is also necessary to seriously interfere with the scrotum with the cutting of such a course and the plasticity of the skin.

Against the background of inflammation in the scrotum, tissue of the spermatic cord may be damaged or secretion of the epithelium of the inner shell of the testicles may be completely suppressed. In one or another situation this leads to the development of infertility.

In addition, infertility can develop and against the background of the formation of scars and adhesions in the seminal cord and tissues that are located around it. This creates a simple mechanical obstacle to the outflow of sperm from the testicle and the appearance of infertility.

To reduce the risk of developing some form of infertility, it is important to prevent the spread of epididymitis to the other side. This can be done only in time by referring for qualified help to the urologist.

Prevention of acute and chronic epididymitis

The first moment in the prevention of epididymitis is the early diagnosis and treatment of this disease. If you determine the pathology in its very debut, then the consequences can not be discussed at all, since the slightest course of antibiotic therapy completely removes all the questions.

The second point in the prevention of epididymitis is sexual life control. Clinical studies and medical practice make it possible to say that most often this pathology affects patients who enter into casual sexual contacts and do not have permanent partners. This leads to infection with sexually transmitted diseases and the occurrence of epididymitis as complications. Therefore, for its prevention it is extremely important to limit the circle of sexual partners and ensure the optimal hygiene of sexual intercourse, which is provided by condoms and other hygiene means.

Another direct cause of epididymitis is frequent multiple ejaculation. In this case, its cause can be not only sexual intercourse, but also prolonged masturbation. After the fifth ejaculation, a man begins to feel a slight soreness in the scrotum, which is supplemented by an increased risk of inflammation of the epididymis. Therefore, urologists advise to ejaculate no more than four times for one sexual act.

Another significant factor, which accounts for almost half of all epididymitis, is hypothermia, and it can be both local and general. In the case of local supercooling, a pathogenic microflora is activated, which is located in the lumen of the urethra. In this case, it moves not only into the bladder, which causes cystitis, but also in the scrotum, where it can cause inflammation of the testicles or their appendages. Therefore, to prevent epididymitis, it is recommended to wear warm underwear in the winter season.

If the body is affected by general hypothermia, it can cause a weakening of immunity and generalization of that flora, which is even very far from the genitourinary system. For example, carious teeth and chronic tonsillitis are the two most common causes, leading to inflammation of the epididymis. It is important to understand the fact that the infection itself, which is in the blood, can not stop in the testes. This, at a minimum, must be preceded by the disease of this part of the body. So, those men who have had cystitis or urethritis, automatically go to the risk zone for epididymitis.

Rev.the doctor the urologist, the sexologist-andrologist Plotnikov А.N.