Treatment of epididymo-orchitis and prevention of the development of pathology

Epididymo-orchitis is an inflammatory disease that affects the male urogenital tract, that is, the epididymis and testicles. It is a combination of two urological pathologies - epididymitis (inflammatory process of the appendages) and orchitis (inflammation of the testicles itself).

Epididymo-orchitis is a common and dangerous urological disease. Its main danger is that in a very short time the inflammatory process spreads from the testicles to other healthy organs of the genitourinary system. This can lead to serious consequences for the male body.

The disease can be unilateral or bilateral, occur in acute or chronic form. Epididymo-orchitis in men develops against the background of an infectious lesion of both the testicles and their appendages. The main risk group is men in the age group from 20 to 45 years. Epididymo-orchitis in children or adolescents is very rare.

Causes of development of epididymo-orchitis

Many men who are diagnosed with this disease wonder about epididymo-orchitis, what it is and what are the reasons for the development of the pathology. All factors that provoke the development of the disease can be divided into two main groups - independent and secondary, that is, associated with another pathological process in the male body.

Independent causes of epididymo-orchitis:

• overheating of the genitals;
• frequent hypothermia of the body;
• torsion of the testicles and epididymis;
• a sharp decrease in the level of immunity;
• wearing tight, constricting underwear made of synthetic materials.

With an inflammatory process such as epididymo-orchitis, the medical history may be associated with the development of other diseases, which play the role of the root cause.

• urethritis, cystitis, prostate diseases;
• infection in the urinary tract;
• infectious pathologies of the gastrointestinal system;
• scrotal injury and further complications;
• sexual arousal, powerful erection without ejaculation;
• inflammatory processes in the pelvis – varicose veins, hemorrhoids.

Considering such a common disease as epididymo-orchitis, Wikipedia emphasizes that it has several varieties. Each of them has its own characteristics, characteristics and symptoms.

Acute epididymo-orchitis - this form of pathology develops sharply and rapidly, usually in the first hours after infection. Accompanied by a rapid increase in body temperature, chills, and a noticeable deterioration in general well-being.

Chronic epididymo-orchitis - the disease can last from several weeks to several months; the clinical picture of epididymo-orchitis is very similar to other pathologies of the genitourinary organs. It is for this reason that in most cases the inflammatory process is diagnosed in the later stages, when serious and long-term treatment is required.

Experts also distinguish postoperative epididymo-orchitis, which is a complication of various surgical interventions on the organs of the small tract or digestive system.

The injected drugs have a negative effect on the condition of the genital organs, leading to redness and swelling of the scrotum, penis and testicles.

Symptoms of the disease

Quite often, men turn to a doctor asking them to explain epididymo-orchitis - what it is, how it is treated, and what manifestations indicate its development. At the initial stage, the inflammatory process practically does not make itself felt; the disease is often completely asymptomatic. As the pathology progresses, the main signs of epididymo-orchitis appear.

• an increase in the size of the inflamed testicle or epididymis;
• increased body temperature, chills, fever at the site of inflammation;
• when palpating the testicles, you can notice a compaction, which indicates the accumulation of pus and fluid;
• redness, swelling in the groin area;
• the appearance of blood or pus in semen or urine;
• sharp, pulling or aching pain in the testicles, which especially intensifies during movement.

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Epididymo-orchitis and epididymitis , developing in an acute form, occur sharply, rapidly, several hours or days after infection. In most cases, the acute form of the inflammatory process begins with an unexpected increase in body temperature up to 40°, while a man may feel heat and swelling in the groin area.

If acute epididymo-orchitis on the right , the patient experiences severe, sharp pain in the area of ​​the right testicle, which can “radiate” to the lower back and groin. Accordingly, acute epididymo-orchitis on the left is accompanied by stabbing painful spasms in the left testicle, which significantly intensify during walking or other active movements.

The acute form of the disease is characterized by weakness, loss of strength, apathy, pain during urination, as well as discharge from the urethra with a characteristic unpleasant odor. In the absence of appropriate treatment, acute pathology develops into chronic.

Chronic epididymo-orchitis is accompanied by serious disturbances in the functioning of the reproductive system. A man may notice that when he gets an erection or tries to have sexual intercourse, there is a sharp, stabbing pain in the scrotum area. Doctors advise all patients diagnosed with this disease to abstain from intimate life until complete recovery.

Diagnosis of epididymo-orchitis

In order to diagnose epididymitis and epididymo-orchitis, you need to consult a urologist. In most cases, diagnosing these pathologies does not cause much difficulty for a specialist. During a visual examination and palpation of the male genital organs, the doctor can determine redness, swelling, and hardening in the testicles and their appendages.

To confirm the diagnosis, the doctor prescribes additional tests and diagnostic measures:

1. General blood and urine analysis.
2. Ultrasound examination of the pelvic organs.
3. Examination of a smear taken from the urethra.
4. PCR analysis.
5. Wasserman reaction.

These diagnostic measures make it possible to establish with maximum accuracy the presence of an inflammatory disease, as well as determine its causes and select the optimal, most effective treatment tactics.

Treatment of epididymo-orchitis

To date, there is no uniform treatment strategy for the inflammatory disease. Treatment of epididymo-orchitis depends on what factors triggered the development of the pathology.

If epididymo-orchitis is caused by bacterial or infectious agents, antibacterial drugs must be used. In order to select the most effective remedy, a smear from the urethra is studied, which makes it possible to identify the causative agent of the disease.

To reduce discomfort, redness and swelling, ointments and gels are used for external use, which have anti-inflammatory, decongestant and regenerating properties.

Warming compresses are recommended among physical therapy methods, but they can only be used as prescribed by a doctor. It should be remembered that warming is strictly prohibited in the presence of purulent accumulations in the area of ​​the testicles and their appendages.

Elimination of painful spasms occurs with the help of analgesics. If the cause of epididymorchitis is injury to the genital organs, it is recommended to use special solutions and ointments that prevent the development of hematoma and reduce the likelihood of inflammation.

When diagnosing a disease such as epididymo-orchitis, treatment requires strict bed rest, adherence to a strict diet, sexual abstinence, and in some cases, wearing a special fixing bandage. If a patient is diagnosed with acute epididymo-orchitis, the recovery time depends on how timely treatment was started.

In the most severe and advanced cases, accompanied by the accumulation of purulent fluid in the scrotum, treatment is carried out through surgery.

Prevention

Epididymo-orchitis, a photo of which can be seen above, can be prevented by following a few simple rules. It is extremely important to have a full sex life; every sexual intercourse should end with ejaculation. At the same time, it is best to have sex with a regular partner and be sure to use contraception.

A man needs to carefully monitor his intimate hygiene, washing his genitals at least 2 times a day. You should choose clothes and underwear that are loose-fitting, made from natural fabrics, and avoid hypothermia or overheating of the genitals.

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It is very important to lead a healthy lifestyle - if possible, stop smoking, limit the consumption of alcoholic beverages, and include foods rich in vitamins, organic acids and microelements in your daily menu. It is also useful for men to engage in any type of physical activity - be it a favorite sport or just walking in the fresh air.

One of the most important methods of prevention is regular visits to the urologist. A man of reproductive age should visit a doctor for preventive examinations at least 2-3 times a year.

Source: https://mzdorov.com/andrologia/vospaleniya/epididimoorhit.html

Epididymo-orchitis

Epididymo-orchitis is a combined inflammation of the testicle and its epididymis of various etiologies. The acute form is characterized by a rise in body temperature to 40°C, chills, a local inflammatory reaction on the affected side with redness, swelling, an increase in the size of the scrotum, and a sharp pain syndrome radiating to the groin. Compaction of the testicle and its inactivity indicate the formation of an infiltrate and possible accumulation of fluid (pus). Epididymo-orchitis is diagnosed based on symptoms, CBC, OAM, urethral smear, STD test, ultrasound. Treatment: suspensions, antibiotics, anti-inflammatory drugs (inpatient or outpatient). Abscess formation is a reason for surgery.

Epididymo-orchitis (orchiepididymitis) is one of the most common inflammatory processes of the scrotal organs, occurring as an independent disease or against the background of another pathology. From an anatomical point of view, combined inflammation in the testicle and epididymis is due to the close connection of these organs. Sperm and testosterone are produced in the testicles, while the epididymis is necessary for the ripening of the seed.

Epididymo-orchitis has been known since the 5th century BC. thanks to the works of Hippocrates on mumps (inflammation of the testicle and epididymis can be a complication of this disease). In 1790, Hamilton finally linked this pathology with damage to the gonads.

The triggers of the pathological process are most often prostatitis and urethritis, so the disease is diagnosed, as a rule, by urologists, less often by andrologists or venereologists. According to statistics, the pathology is most common among men aged 20 to 40 years, and has no pronounced seasonality, endemicity, or racial priorities.

The urgency of the problem is due to the complications of epididymo-orchitis, one of which is male infertility.

Epididymo-orchitis

There are independent epididymo-orchitis, which occurs as a result of temperature changes, wearing tight underwear, twisting of the testicle and its appendages, decreased immunity, and inflammation of the testicle and epididymis as a complication of another disease: urethritis, prostatitis, local infections (including sexually transmitted infections), inflammatory processes in the small pelvis (varicose veins, hemorrhoids, paraproctitis), tonsillitis, etc. Contact epididymo-orchitis can develop due to trauma to the scrotum, complications after prostate surgery, endoscopic intervention, catheterization, prolonged sexual arousal with an erection, but without ejaculation, incorrect therapy pathologies of the genitourinary organs.

In modern andrology, according to the nature of the course, epididymo-orchitis is divided into acute (developing in the first hours after exposure to the etiological factor), subacute (occurring during the first week) and chronic. Chronic processes, as a rule, are masked by the symptoms of another disease, which prolongs the development of inflammation by weeks and even months.

Etiologically, specific and nonspecific epididymo-orchitis are distinguished.

1. Specific inflammation of the scrotal organs includes tuberculosis, syphilitic and brucellosis pathological processes, which arise under the influence of specific pathogens and are characterized by certain morphological signs.
2. Nonspecific epididymo-orchitis occurs against the background of infection with fungi, protozoa (Trichomonas), bacteria (cocci, mycoplasmas, chlamydia, Escherichia coli, Proteus, Klebsiella), influenza viruses, rubella and mumps, and enteroviruses.

There is also a division of epididymo-orchitis in accordance with the routes of infection into the testicle and epididymis.

There are hematogenous (with blood flow), lymphogenous (through the lymphatic tract) and retrograde (from the urethra along the vas deferens to the cord and epididymis) infection.

The mechanism of entry of tuberculosis bacilli into the scrotal cavity is not completely clear, most likely lymphogenous and hematogenous penetration. STDs are characterized by a retrograde route of infection. For nonspecific microflora such as viruses, fungi, most bacteria - hematogenous.

Acute epididymo-orchitis is manifested by high temperature (up to 40°) and sharp pain that radiates to the lower back and lower abdomen, intensifying when walking.

Due to the severe symptoms of the disease, patients quickly consult a doctor.

Associated manifestations of the pathology are weakness, weakness, myalgia, signs of local inflammation, discharge from the urethra with an unpleasant odor and pain when urinating.

When the immune system is weakened or there is a massive attack of microbes, the acute form of the disease can transform into purulent epididymo-orchitis, in which severe general intoxication and damage to other organs of the genitourinary system are observed. Sepsis and testicular infarction are possible. The danger of progression of epididymo-orchitis lies in the occurrence of a bilateral process.

With subacute epididymo-orchitis, all symptoms are less intense. The chronic version of the disease is characterized by a prodrome, moderate pain in the scrotum, aggravated by movement and palpation, high testicular density, decreased libido, changes in the composition of sperm due to impurities of pus and red blood cells, and an unpleasant odor of discharge.

The slow progression of the pathology makes it possible to prescribe adequate therapy in a timely manner and avoid serious complications.

However, subacute or chronic epididymo-orchitis can be complicated by the formation of scrotal fistulas, fibrosis of the testicle and epididymis with the development of infertility (with bilateral damage), and malignancy.

Bilateral damage entails decreased libido and erectile dysfunction.

Typically, a clinical diagnosis is made by a urologist or andrologist based on anamnesis, objective examination of the scrotal organs and additional research methods. Examination for epididymo-orchitis includes:

• CBC, BAM, biochemical blood test;
• bacteriological examination of urine;
• urethral smear (often with antibiotic sensitivity culture);
• PCR diagnostics;
• examination of sperm and prostate juice (general and bacteriological);
• PSA blood test;
• urethroscopy;
• Ultrasound of the scrotum.

When diagnosing epididymo-orchitis, there is a rule of mandatory examination of the sexual partner for the presence of sexually transmitted infections.

Treatment of epididymo-orchitis should begin immediately after diagnosis. Therapy is usually carried out in a hospital; only exacerbation of the chronic process is treated on an outpatient basis. The complex of therapeutic measures for epididymo-orchitis includes bed or semi-bed rest, wearing a jockstrap, a diet with limited sweet, spicy, salty foods and a predominance of animal proteins.

Drug therapy for epididymo-orchitis consists of prescribing broad-spectrum antibiotics for a period of 7-10 days with a control culture of microflora from the urethra. Treatment can be adjusted after receiving the results of bacteriological examination (urine, semen, prostate secretions). In addition to antibiotics, anti-inflammatory drugs, regeneration stimulants and immunomodulators are indicated.

Physiotherapy is also used in treatment: UHF of the scrotum, magnetic procedures, paraffin baths, iodine electrophoresis against the background of the subsidence of the inflammatory process.

In case of suppuration, heart attack, testicular fistula and cord torsion, surgical intervention is indicated. If an STD is detected, the partner is given preventive treatment.

Prevention of epididymo-orchitis includes the absence of casual sex and the use of condoms. It is recommended to avoid hypothermia and overheating and wear underwear made from natural fabrics. In case of injuries to the groin area, you should consult a specialist.

It is necessary to sanitize foci of infections in a timely manner, and do not neglect the rules of personal hygiene. The prognosis in case of timely adequate treatment is favorable. In advanced cases, infertility, testicular necrosis, or malignant degeneration of tissue in the affected area is possible.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_andrology/epididymo-orchitis

Effective treatment of inflammation of the testicles and their appendages

Sometimes men have to deal with very unpleasant diseases that affect the holy of holies - the genitals.

Similar pathologies include epididymo-orchitis, an inflammatory process that affects the testicles and their appendages. A similar disease occurs when these organs are simultaneously infected.

Statistics show that men in the 20-40 year old age group are most susceptible to this pathology.

How does testicular pathology manifest?

A specialist usually does not have problems diagnosing epididymo-orchitis, since the pathology is distinguished by a clear set of symptoms indicating the course of the infectious process in the epididymis and testicle. Characteristic signs of such a pathology are:

1. Increased temperature both throughout the body and at the site of the lesion. When palpated, the inflamed side of the scrotum affected by the disease is hotter than the healthy half;
2. An increase in the size of the epididymis and the testicle itself; when touched, a noticeable decrease in their mobility relative to each other is felt, they become denser, and fluid begins to accumulate in the scrotum;
3. Pain in the affected scrotum, radiating to the spermatic cord and groin. When touched, the pain intensifies, and at rest it acquires a nagging, aching character;
4. Chills;
5. Swelling and local redness of the affected organ;
6. In some cases, pus begins to accumulate in the tissues of the scrotum, which usually dries out on its own over time, but sometimes there is a need for surgical drainage of the pus.

If epididymo-orchitis is of a specific nature, developing against the background of some other disease such as tuberculosis, syphilis, gonorrhea and others, then its clinical picture becomes somewhat blurred. The signs of the underlying disease manifest themselves most clearly, and inflammation of the testicle and epididymis becomes chronic and is practically asymptomatic:

• The pathology of tuberculous etiology is characterized by general weakness, subfebrile temperature, usually both testicles and appendages are affected, small hardenings appear in the scrotum, and with advanced disease, fistulas begin to form in the testicles;
• The gonorrheal form of the pathology is characterized by scrotal soreness, elevated temperature, thickening of the duct and the appearance of slight discharge from the urethra.

Therefore, the disease requires careful diagnosis. The urologist examines the patient, sends him for an ultrasound examination, examines the medical history and prescribes laboratory tests (blood drawing, urethral smear, urine, etc.). Only after all the studies have been completed, the doctor makes a diagnosis and prescribes the necessary therapeutic course.

Why does epididymo-orchitis occur?

Inflammation of the testicle and its epididymis can be specific (tuberculosis, trichomonas, etc.) and nonspecific. Each clinical case is characterized by its own causes and pathogenesis of the disease. Pathogenic infectious agents penetrate the testicle and epididymis through the blood or the vas deferens.

Most often, such agents are staphylococcal, gonococcal, streptococcal, and tuberculosis pathogens.

Thus, the gonorrheal form of pathology occurs as a result of complications of gonorrheal inflammation of the urethra, its improper treatment and chronicity, in which the pathogen penetrates into the vas deferens, and then into the epididymis and testicle.

Tuberculous epididymo-orchitis is considered the most difficult to explain. Experts do not fully understand the mechanism by which the pathogen enters the scrotal cavity and the subsequent initiation of the infectious process.

Therefore, during an infection of a tuberculous nature, the epididymis and testicle are characterized by isolated lesions.

In the case of Trichomonas epididymo-orchitis, the cause of the pathology is advanced trichomoniasis or its improper therapy.

In general, doctors identify the following etiological factors of pathology:

• Surgery on the prostate;
• Complication after injury to the scrotum;
• Inflammatory diseases of the pelvic organs such as varicose veins, hemorrhoids, proctitis or paraproctitis;
• Viral pathologies transmitted through sexual contact;
• Significant pelvic hypothermia or overheating;
• Infectious pathologies of the digestive organs;
• Torsion of the epididymis or testicle;
• Complicated inflammation of the urethra or prostate gland;
• Postoperative complication of endoscopy or catheterization of the urethra, bladder, etc.;
• Infectious pathologies such as flu or sore throat;
• Frequent sexual arousal with erection without subsequent ejaculation;
• Irrational therapy of infectious pathologies.

The inflammatory process begins with the penetration of microorganisms into the ducts or blood, then, against the background of weak immune defense, an infection develops.

There is no categorical information that nonspecific epididymo-orchitis develops as a result of the negative influence of a specific pathogen or a specific disease, since the pathology develops in accordance with the individual characteristics of the body and under the influence of a whole complex of processes.

Inflammation of this kind against the background of traditional tissue irritation develops in extremely rare cases.

The likelihood of developing pathology increases in the event of a sharp increase in physical stress, characteristic of an unusual type of activity that the patient has not previously engaged in.

Depending on the root cause and type of pathology, the urologist selects appropriate therapy and subsequent prevention of the disease.

Methods of treating the disease

Treatment of pathology does not have a clear therapeutic regimen, since each case is unique and requires mandatory medical intervention. Nonspecific pathology involves a number of activities. To begin with, treatment is based on taking powerful antibiotic drugs of the tetracycline, cephalosporin, fluoroquinolone and aminoglycoside series.

In addition, treatment requires adherence to a strict diet and bed rest. It is recommended to apply ice compresses to the scrotal area, and during the day to wear special underwear that secures the scrotum properly (suspensor).

Early surgical interventions have significant advantages, since with their help in almost all cases it is possible to preserve the fertile capabilities of a man, but such treatment is permissible only in case of suppuration.

If we talk about specific types of pathology, then therapy depends on the type of pathogen that caused the inflammation. The most difficult to treat form is tuberculous epididymo-orchitis.

It is characterized by latent development, so the patient sees a doctor when the pathology takes on severe, advanced forms. This type of disease is characterized by the presence of concomitant lesions of the prostate, bladder or kidneys.

The treatment regimen is anti-tuberculosis in nature, and the patient must be admitted to a hospital.

In general, therapy for epididymo-orchitis is aimed at stopping the inflammatory process, restoring all functions of the testicles and appendages, as well as resolving the inflammatory-infectious focus.

The disease of trichomonas etiology requires an integrated therapeutic approach. They resort to antibiotic therapy, immunomodulatory treatment, and trichovaccination. At the final stage, general restorative therapy and strict control over the presence of Trichomonas pathogens are assumed.

Inflammation of the epididymis and testicle of gonococcal etiology can be eliminated with the help of adequate and properly selected antibiotic therapy. After treatment, the patient again has to undergo tests to confirm the absence of the pathogen.

In this situation, it is important to prevent repeated exacerbations of the disease, in which the resistance of the gonococcal pathogen to antibiotic drugs increases significantly.

The seal around the appendage usually resolves after a couple of months, but thermal treatment (paraffin therapy, diathermy, mud therapy, etc.) will help speed up this process.

In addition to taking antibiotics, antimicrobial, anti-inflammatory drugs, and physiotherapeutic procedures such as UHF or ultrasound are prescribed. Surgical therapy in practice is used quite rarely in case of ineffectiveness of drug treatment or in case of severe tuberculosis infection. Sometimes surgery is indicated to prevent the disease from spreading to the second testicle and epididymis.

Important! During the entire therapeutic course, it is necessary to abstain from alcohol, sexual intercourse, spicy food, physical overexertion, hypothermia, etc. Then the effectiveness of treatment increases significantly, and the risk of relapse disappears.

Source: http://DoktorSos.com/andrologija/vospalenie/epididimoorxit.html

Epididymo-orchitis

This is an inflammatory process that directly affects the male testicle and its appendage. There are acute and chronic forms of the disease. It is characterized by a change in the general condition of the man and the development of local intense pain syndrome. Chronic inflammation of the male testicle can lead to irreversible infertility.

The inflammatory process of the epididymis (epididymitis) is formed as a result of the penetration of bacterial flora from the urinary tract. Most often, epididymitis is provoked by various gram-negative microbial agents (Klebsiella, Proteus, Escherichia coli).

In men of active reproductive age, the development of epididymo-orchitis as a result of exposure to specific agents (chlamydia, gonococcus) is more typical. The inflammatory-dystrophic process spreads from the epididymis (in the absence of proper treatment) to the testicle.

Orchitis itself , as the initial stage of epididymo-orchitis, occurs primarily as a result of hematogenous dissemination of a microbial agent. Most often these are various types of viruses: the causative agent of mumps.

Most men develop unilateral epididymo-orchitis.

The acute version of epididymo-orchitis is characterized by changes in the general condition and local symptoms. A change in general condition is manifested by a significant increase in temperature, general loss of strength, and weakness.  

Local symptoms include:

• severe throbbing or burning pain in the lower abdomen or just the scrotum;
• pain increases with movement and touch;
• There is often pain during urination;
• the male testicle is significantly enlarged in size, swollen and sharply painful;
• pain decreases somewhat when lifting the scrotum or putting on tight underwear (swimming trunks).

The acute version of epididymo-orchitis can be complicated by the formation of a fistula, abscess, hydrocele or pyocele.

The chronic version of epididymo-orchitis in most reported cases is the result of an improperly treated acute version of the disease. Usually the pain syndrome is moderate, which is an obstacle to the necessary treatment. A complication (outcome) of chronic epididymo-orchitis is irreversible male infertility.

• The diagnosis of epididymo-orchitis is made based on the clinical symptoms of the disease. To establish a detailed clinical diagnosis, the following methods can be used:
• - detailed urine analysis and bacteriological culture ;
• - spermogram in case of chronic epididymo-orchitis to assess the impairment of a man’s fertility;

— Ultrasound of the scrotum (detection of swelling and other inflammatory signs).

Therapy for the acute version of epididymo-orchitis consists of prescribing antibiotics with a wide spectrum of bactericidal effect. A mandatory component is powerful pain relief with NSAIDs, local novocaine blockade or narcotic analgesics.

Treatment of the chronic version of epididymo-orchitis consists of restoring reproductive function.

Prevention of this disease is based on compliance with hygiene rules, avoidance of hypothermia and the use of barrier contraception.  

Source: https://medcentr-Endomedlab.ru/jepididimoorhit.html

Epididymo-orchitis: causes, signs, symptoms, treatment

Epididymo-orchitis is an inflammatory process in the area of ​​the testicle and its epididymis. As a rule, the pathological process begins with the tail of the appendage and gradually spreads to the entire organ. The main risk group is men in the age group 20–40 years. In 5% of cases, this disease requires hospitalization and surgical treatment.

Online consultation on the disease “Epididymo-orchitis”.

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Etiology

The etiological reasons for the development of this inflammatory process can be divided into two groups - independent and as a complication due to another ailment. The first group includes the following factors:

• frequent hypothermia;
• overheat;
• prolonged and systematic wearing of tight underwear;
• frequent torsion of the testicle and its epididymis.

Contact (consequence of other pathological processes) epididymo-orchitis can develop due to the following factors:

• through infection of the urinary canal;
• in the presence of prostatitis, urethritis;
• infectious diseases of the gastrointestinal tract;
• complications after endoscopy;
• sexual overexcitation with a strong erection, but without ejaculation;
• complication after scrotal injury;
• in the presence of inflammatory diseases in the pelvic organs.

Clinicians also note that in more rare cases, the development of this inflammatory process is possible through the hematogenous route with sore throat or flu.

General symptoms

At the initial stage of development of epididymo-orchitis, symptoms may not appear, which significantly complicates further treatment. As the inflammatory process develops, the following symptoms can be observed:

• increased temperature of the whole body and locally, at the site of inflammation;
• an increase in the size of the affected testicle and epididymis;
• upon palpation, a compaction is felt in the testicle area, which indicates the accumulation of fluid;
• in the scrotum area there is a sharp pain when moving, which can radiate to the groin. At rest, the pain is aching in nature;
• swelling, severe redness of the affected area;
• chills.

In the chronic form of the disease, pus may accumulate in the scrotum. In some cases, it dries out on its own. Otherwise, surgical drainage is required.

It should be noted that if the inflammatory process develops against the background of another disease, the symptoms listed above may be absent. The clinical picture may appear as follows:

• Unstable body temperature and in the area of ​​the affected organ;
• the presence of small seals in the scrotum;
• pain may appear periodically;
• third-party discharge from the urethra;
• difficulty urinating.

In advanced forms of this disease, seals in the scrotum can turn into fistulas.

Classification

Based on the nature of the course of epididymo-orchitis, two forms are distinguished:

Clinicians note that the acute stage of development of the inflammatory process is much more treatable than chronic pathology.

Diagnostics

At the first symptoms, you should immediately consult a doctor. Self-medication can lead to serious complications.

After the initial examination and clarification of the medical history, additional diagnostics are carried out. The standard program includes the following:

• general and biochemical blood tests;
• STD test;
• Ultrasound of the scrotum and genitourinary system;
• urethral smear;
• general urine examination.

If, based on the results of these tests, it is impossible to identify the cause of the development of the inflammatory process, differential diagnostic methods are used.

Treatment

As a rule, in the acute form of epididymo-orchitis, drug therapy is sufficient; surgical intervention is not required. Treatment of the disease includes the following:

• drug therapy;
• wearing a special support bandage;
• strict bed rest.

Drug therapy for the treatment of acute and chronic forms of the disease includes taking the following drugs:

• antibiotics;
• anti-inflammatory;
• aminoglycosides.

The regimen, dosage and duration of taking medications are prescribed only by the attending physician. Using any medications on your own, or using folk remedies, can only aggravate the situation and provoke a serious complication. If conservative treatment does not give proper results, surgical intervention is used to eliminate the lesion.

It should be noted that with timely treatment and properly selected drug therapy, this disease does not lead to complications.

Prevention

Prevention of the disease includes the following measures:

• timely treatment of all inflammatory and infectious diseases;
• wearing comfortable underwear made of natural fabric;
• prevention of overheating or hypothermia of the genitourinary system;
• maintaining a healthy lifestyle.

Compliance with these simple rules in practice makes it possible to prevent the development of not only epididymo-orchitis, but also other ailments of the genitourinary system.

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Source: https://SimptoMer.ru/bolezni/muzhskie-zabolevaniya/1828-epididimoorkhit-simptomy

Epididymo-orchitis - symptoms, causes, treatment, drugs, in children

Epididymo-orchitis is a combined inflammation of the testicles and their appendages. Often the inflammatory process affects either only the appendages or only the testicles. In the first case, the disease occurs in the form of epididymitis, and in the second - in the form of orchitis.

Epididymitis usually develops as a result of infection. The introduction of pathogenic microbes occurs through blood vessels or the vas deferens.

The causative agents of infection are gonococci, tuberculosis bacillus, streptococci, staphylococci, and less commonly other types of bacteria.

The risk of disease increases with unusual physical stress, including, first of all, a type of work activity that you have never had to do before. Other factors include irrational treatment of infections, frequent erections without subsequent ejaculation, and instrumental interventions such as bladder catheterization.

Epididymitis as a complication of gonorrhea, tuberculosis or any other specific infection occurs in an acute form.

The clinical picture of acute epididymitis includes high fever, chills, pronounced swelling of the skin of the scrotum, enlargement and tenderness of the appendage (these signs are detectable by touch), as well as severe pain involving the scrotum and groin area.

Scrotal pain with unilateral lesions is localized in the area of ​​the pathological focus. This is characteristic primarily of gonorrheal inflammation.

With specific epididymitis, during the period of active inflammatory process, the amount of purulent discharge from the urethra, which is typical for the vast majority of sexually transmitted infections, becomes extremely insignificant. Sometimes such discharge is completely absent.

Nonspecific epididymitis, caused by streptococcal or staphylococcal infection, usually occurs in a subacute form, which is characterized by malaise and weakness of the patient. Enlargement of the appendage is not detected immediately, because its size changes slowly.

If the pathological process in the acute or subacute form could not be completely and promptly suppressed, then it leads to the occurrence of chronic epididymitis (most often of a nonspecific nature). Body temperature during the chronic course of the disease is normal. Palpation of the scrotum reveals an enlargement of the affected appendage, which is clearly demarcated from the testicle.

Most often, testicular damage is observed as a result of tuberculous epididymitis, which after a long time leads to the development of scrotal fistulas.

A complication of acute epididymitis is the formation of scars on the epididymis and vas deferens, which impede the passage of the seed. Therefore, with bilateral epididymitis, infertility occurs in 75% of cases.

Surgical treatment of epididymitis is practiced relatively rarely. The indications for surgical intervention are, firstly, severe tuberculosis infection, and secondly, the lack of results with conservative treatment. In some cases, surgery is prescribed to prevent disease of the second appendage.

Treatment of acute epididymitis at home is not allowed, however, there is a set of measures to provide first aid during a painful attack. This complex includes bed rest and measures to relieve pain.

Warmth in the scrotum and groin area (in the form of hot water bottles or warm Vaseline compresses) helps reduce pain.

Cold is contraindicated, except for unbearable pain, when a cold compress can be used for a short time.

At home, after discharge from the hospital, the patient undergoes a course of drug therapy in order to finally eliminate inflammatory phenomena and prevent suppuration of the appendage.

Antibiotics may also be used.

When epididymitis is caused by gonorrhea, syphilis or trichomoniasis, sulfonamides are almost never used, but antibiotics that suppress the pathogen are used. Recommended drugs are doxacycline, tetracycline, erythromycin or, mainly for older people, Bactrim, Biseptol or Septrin.

Throughout the entire period of treatment, it is necessary to follow certain rules in order to avoid complications and intensification of painful phenomena: abstain from sexual activity, do not drink alcohol, and exclude spicy foods from your diet.

Infiltration (compaction) in the area of ​​the appendage persists for quite a long time, up to 2 months. Its rapid resorption is facilitated by thermal procedures, which are recommended for the patient after discharge from the hospital.

They usually come down to paraffin therapy, mud therapy, ozokerite therapy or diathermy.

As the disease is treated, its symptoms change. The temperature decreases and, even with subsequent possible fluctuations, rarely rises above 37.5 'C (never to 38 * C). The patient's health is satisfactory.

Suppression of the inflammatory process in the appendages with specific epididymitis may be indicated by the resumption of suppuration from the urethra (if purulent discharge was noted earlier, before the onset of epididymitis).

Recovery usually occurs after 5-7 days, and with effective treatment - even earlier.

It is also necessary to protect the body, especially the scrotum and groin area, from hypothermia.

It is advisable to abandon the practice of interrupted sexual intercourse, which provokes congestion in the pelvic area and overflow of the appendages, which causes the development of the inflammatory process.

Isolated inflammation of the testicle, or orchitis, most often occurs as a result of penetration into the scrotum through the bloodstream of a descending infection from distant foci, of which the main ones are the respiratory organs. Typical cases of orchitis development as a result of pneumonia or ARVI. Also, a viral infection with mumps (mumps) penetrates into the testicle by hematogenous route.

Much less often inflammation occurs from nearby foci through the epididymis and vas deferens, which is observed with prostatitis, epididymitis and a number of other diseases. Sexual infections usually affect the epididymis and rarely penetrate the testicle, with the exception of syphilis, the causative agent of which acts in exactly the opposite way, i.e., it infects the testicle and almost does not affect the epididymis.

Acute orchitis is characterized by the sudden onset of its symptoms, which include severe and prolonged pain in the affected testicle, an increase in its size, swelling and redness of the skin of the scrotum, very high fever, accompanied by chills.

From an acute form, the disease can become chronic, but in some cases, namely with syphilitic or tuberculosis infection, it immediately takes a chronic course, in which the symptoms are less pronounced.

In severe or advanced cases, the inflammatory process turns into suppuration, while the abscess grows and covers the area of ​​tissue adjacent to the testicle, incl.

A complication of orchitis is in some cases epididymitis, and the disease proceeds as epididymo-orchitis. Also, with orchitis, damage to the functional tissue of the testicle is almost inevitable.

In the latter case, atrophy of the spermatogenic epithelium occurs, which entails the cessation of the production of gametes (sex cells) by the testis. Therefore, with bilateral orchitis, a man develops infertility, complicated by impaired secretory function of the testes.

Suppuration is especially dangerous, since when the abscess grows, the functional tissue of the testicle completely dies.

Radical treatment is rarely required - with the risk of bilateral inflammation, suppuration, fistulas. The patient is prescribed strict bed rest. The scrotum is given an elevated position, for which a wad of cotton wool, a bandage, a cloth roller, etc. are placed under it.

To relieve severe pain, cold compresses are briefly applied to the scrotum and groin area. If the pain can be tolerated, it is best to use heat (heating pads, etc.).

After the main treatment, the doctor prescribes antibiotics and sulfonamides, depending on the type of infectious agent.

One of the leading signs of suppression of the inflammatory process should be the subsidence of pain and, after 2-3 days, a noticeable decrease in temperature (although it may remain within 37.5 ° C for some time). The size of the testicle, however, remains enlarged for a long time.

Source: http://www.urological.ru/556.html