The male reproductive system is just as often affected by diseases as the female. Therefore, you need to carefully monitor your health and visit a urologist at least once a year.
If a disease such as epididymitis orchioepididymitis is not detected in time, you may have a number of complications in the future, including infertility.
The presented disorder includes two types of inflammation of the male organs.
Orchiepididymitis: how the disease is expressed
This disease is a combination of two ailments: orchitis (inflammatory process in the testis) and epididymitis (inflammation of the appendages).
Since these two organs are closely related, the cause of inflammation can be both orchitis and epididymitis. Sometimes it is quite difficult to determine whether inflammation occurs only in the testis or whether the appendages are also affected.
Although doctors note that orchitis often resolves locally (without affecting other organs), epididymitis also spreads to the testicles.
Causes of orchiepididymitis
Basically, the disease develops as a result of an infectious disease. Most often, the infection is transmitted sexually, and the following microorganisms accompany it:
- Gonococci
- Chlamydia
- Trichomonas
That is, the causative agents of orchiepididymitis are often sexually transmitted diseases (gonorrhea, syphilis, trichomoniasis). The disease can also be caused by viral infections of the genital organs (urethritis, prostatitis). Men of active puberty and mature people with prostate disease are at risk. Pediatric orchiepididymitis also occurs in children, but it very rarely occurs in 1% of cases.
Traumatic orchiepididymitis is also distinguished. Main reasons:
- Kick to the groin
- Fall on crotch
- Testicular injury
- Postoperative period
In this case, swelling of the testicle is possible, which leads to its inflammation. Risk factors include:
- Hypothermia or overheating of the body
- Past viral diseases (influenza, pneumonia, parainfluenza)
- Surgeries on the genital organs
In very rare cases, tuberculosis is the cause of epididymitis orchiitis. Typically, the tuberculosis virus does not adversely affect the reproductive system.
Symptoms of the disease
In order for the doctor to prescribe the correct treatment, which will not lead to complications, you need to know the etymology of the disease. The symptom of orchiepididymitis cannot be ignored, because it almost always manifests itself in an acute form:
- Temperature rise up to 40 0C
- Pain in the groin, perineum
- Swelling of the testis
- Painful urination. In this case, the stream is thin and intermittent
- Sharp pain in the scrotum area. In this case, the organ has obvious signs of inflammation (turns red)
- Blood in sperm
The disease is sudden. That is, initially the patient may not even realize that an inflammatory process is beginning. The disease only needs one day to knock the patient off his feet. Ideally, with timely treatment with antibiotics, symptoms go away within seven days. In more severe cases – 10 days. But if an abscess (pus) develops, the patient may be hospitalized.
There are three types of symptoms:
- Acute
- Chronic
- Abscessive
The acute form manifests itself instantly and often gives false pain in those areas where the pain should not be localized, but due to swelling the patient can feel pain even in the lower back. Acute orchiepididymitis on the right is observed less frequently than on the left. This is due to the anatomical structure of the male genital organs.
The big disadvantage of epididymitis orchioepididymitis is that it can take a chronic form and appear when the environment is favorable for it (cold, overheating, infection), etc.
The chronic course of the disease causes a lot of inconvenience for men. They may experience aching pain in the groin and scrotum, but the most dangerous thing is if the chronic form becomes abscessive with suppuration.
Therefore, you should not hesitate if you have a chronic illness.
Diagnosis of orchiepididymitis
To avoid an incorrect diagnosis, the patient is offered to undergo a full range of examinations. This is necessary in order to identify the root cause of the disease and find out the nature of its occurrence.
A doctor's examination alone is not enough.
Diagnosis of this disease is carried out only by a urologist, who must manage the patient’s illness. Of the standard tests, the patient must pass:
- Analysis of urine
- Blood analysis
- Bakposev
Also, the doctor must urgently take a smear from the urethra to identify the cause of the disease (infection, bacteria, virus). Ultrasound is prescribed in case of swelling of the scrotum. Thanks to this study, the doctor will be able to see if there is pus in the testicle or appendages. A puncture is taken if there is an abscess (to investigate the cause of suppuration).
The presented studies help to build a clear picture of what is happening in order to prescribe competent treatment.
Treatment of orchiepididymitis
Often, treatment is carried out only in a hospital under the supervision of doctors.
As has already been mentioned, this disease can strike a person not only on the genitourinary system, but also on the body as a whole, since a rise in temperature to 40 0C, chills, fever, and systematic pain completely exhaust a person. Therefore, if the doctor suggests treatment in a hospital, you should not give preference to home.
- Epididymitis orchioepididymitis is initially treated with broad-spectrum antibiotics, since it is not always possible to identify what caused the inflammation, although when making an accurate diagnosis, a antibiotic .
- List of drugs that are prescribed for the treatment of epididymitis orchioepididymitis:
- ampicillin (docillin, semicillin, ampic, roscillin, dedompil)
- drugs of the penicillin group (ospamox, amine, amoxiclav)
- aminoglycosides (gentosep, garamycin)
- tetracycline group agents
- macrolide antibiotics (Clabax, Klacid)
- fluoroquinols (tarivid, ofloxin, oflocid)
- azalide antibiotics (sumamed)
Only a doctor can tell which drug is best to take, knowing the patient’s medical history. If the drugs are selected incorrectly, the patient may experience side effects and complications. The treatment period is also determined by the doctor.
Self-treatment at home will not lead to the desired result. With a 90% probability, doctors change one type of antibiotic to another during treatment and look at the course of the disease, comparing the indicators.
Therefore, it is impossible to get a good treatment at home.
Due to the fact that many people know about the antibiotics that are usually prescribed for orchiepididymitis, they are in no hurry to consult a doctor. This is fundamentally wrong for the patient himself. Along with taking an antibiotic, the specialist prescribes homeopathic remedies and vitamins E to maintain and stimulate the immune system.
Nonsteroidal drugs such as diclofenac, ofen, ketanol, etc. help:
- Relieve inflammation
- Swelling
- Regenerate cells
In addition to anti-inflammatory therapy, the patient may be prescribed anti-pain therapy aimed at reducing pain, but it is relevant only in the first days of the disease, when the pain syndrome is increased.
Important: the dosage of drugs must be strictly observed by the patient. Otherwise, the patient’s situation can worsen, even leading to death.
The course of treatment for the chronic form of orchiepididymitis is much slower due to the etiology of the disease. Almost always, broad-spectrum drugs are first prescribed, as in acute cases, but the duration of the course may be longer and new drugs may be added. In the abscessive form, the lesion is opened through surgery.
Important: if you do not seek help in time, having an abscessive form of the disease, the testicle may be removed, which in turn will affect reproductive function.
The rehabilitation period varies from 3-4 weeks to 6 months. If the diagnosis revealed sexually transmitted causes of the disease (gonococcal bacteria, chlamydia), then all partners who had contact with the patient should undergo treatment.
Summary
Inflammation of two organs at once (testicles and appendages) can harm the male body to a greater extent. Therefore, if there are obvious signs of a disease of the genitourinary system, it is better to suppress the development of the disease in its infancy. Otherwise, long and painful treatment cannot be avoided.
Today, epididymitis orchiepididymitis is treated with high quality by our doctors, with the preservation of all important sexual functions, in particular such as the ability to have children.
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Source: https://zhiv-zdorov.ru/urologiya/yaichki/orhoepididimit
Treatment of acute and chronic forms of orchiepididymitis
Orchiepididymitis is an inflammatory process involving the epididymis and the testicle itself. This is a fairly common problem encountered in urological practice. The epididymis is anatomically located along the posterior wall of the testicle: it is the connecting link of the testicle with the vas deferens.
Orchiepididymitis is inflammation of the testicle and its epididymis.
The pathological process develops both independently and as a complication of the main infection present in the body - influenza, mumps, pneumonia. The disease has an infectious and non-infectious origin and requires immediate attention to a urologist. If appropriate therapeutic measures are not taken, the possibility of infertility cannot be ruled out.
Causes
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There are several causes of inflammation of such a vulnerable anatomical structure as the epididymis. They are classified into two groups - inflammation of infectious origin and caused by factors of chemical and mechanical origin.
-
Sexual infections cause orchiepididymitis in most cases.
Suffered damage. Sports injuries, consequences of intervention on the genital tissues (inept use of a urinary catheter, recent surgery in the groin area).
- Bacterial microflora. In young men, the disease is caused by sexually transmitted infections (trichomoniasis, gonorrhea, chlamydia). Patients over 40 years of age suffer from orchiepididymitis, which occurs in response to the penetration of E. coli, a pathogenic microorganism that is found in the digestive tract, into the testicular tissue.
- Untreated diseases affecting the urinary tract or prostate gland.
A predisposing factor to the development of inflammation of the epididymis is a preference for anal sex, taking certain medications, and periodic stagnation of urine (mainly when an adenoma, a benign tumor, has formed in the prostate tissue). Fungal flora and mycobacteria, despite their pathogenic ability, rarely become a source of inflammation inside the testicle.
Symptoms
Depending on the form of the disease, manifestations of the pathological process become noticeable within a day after the negative impact on the organ. The disease occurs in acute and chronic forms.
If inflammation is not stopped in the first phase, the process becomes sluggish, causing not only constant discomfort, but also certain complications.
It is possible to determine in what form epididymitis orchioepididymitis occurs by observing the nature and manifestations of symptoms.
Acute form
The disease begins suddenly, the first signs that attract attention are severe discomfort during physical activity and the inability to remain in a sitting position. Other pathological phenomena are divided into the following categories:
Pain, swelling and redness of the scrotum are the main signs of epididymitis orchioepididymitis.
Pain syndrome. The pain spreads to the testicle (in some clinical cases, to both at once - then the disease is called bilateral orchiepididymitis), scrotum, and perineum. An intense unpleasant sensation makes it impossible to walk or rest normally, and when it comes into contact with clothing, it intensifies. Accompanies the entire period of the disease.- Hyperthermic syndrome. The affected area of the intimate area is hot to the touch, the general body temperature also rises to high levels, the patient experiences chills and malaise. When the fever worsens, the man has a headache and aches in the muscles and bones.
- Swelling and redness of the scrotum. The inflamed testicle increases in size, reaching a value 3-4 times greater than the physiological parameters of a healthy male organ.
- Inflammation of the lymph nodes. Regional segments that are part of the human immune system become inflamed, indicating the presence of pathology in the area where they are located.
- Problems with urination. Urine excretion occurs more frequently, and an admixture of blood (hematuria) can be visualized in its composition.
In certain cases, the seminal ducts are involved in the process, which causes the formation of a specific dense cord in the groin area.
Chronic form
Symptoms persist for over six months. The size of the scrotum is often not increased: this misleads the patient, reassuring him that the disease has subsided without the need for drug intervention.
The fertilizing ability of sperm is reduced, the condition is complicated by inflammation of the spermatic cord.
Attempts to palpate the tissue of the appendage cause the patient significant pain; the rest of the time, discomfort occurs only during physical activity (unlike the acute form of the disease, when an unpleasant sensation bothers you even in a lying position).
The only factor why the disease becomes chronic is long-term delay in treatment and reluctance to see a doctor.
Diagnostics
An examination is a logical action for a patient who is concerned about the manifestations of the disease in question. A urologist will suggest you undergo diagnostics - this is the specialist you should contact if you notice pain, testicular swelling, increased body temperature and chills.
Data collection. The doctor interviews the man, collecting information about his main complaints regarding the condition of the reproductive organ, and clarifies the nature and characteristics of his sexual life (to suggest a connection between epididymitis orchitis and a sexually transmitted infection).
The urologist needs to know whether the patient has recently undergone surgery on the groin area, or whether he has had a urethral catheter installed.
Important information - whether there have been any recent injuries to the scrotum (impacts, compression, falls), how long ago the man suffered from viral illnesses.
Inspection. The next stage of diagnosis is examination. The urologist puts on disposable gloves and asks the patient to lie down on the couch. Then he examines the affected area.
If epididymitis orchioepididymitis is unilateral, the scrotum will be skewed to one side, and asymmetrical edema, combined with a purple color of the testicle and general hyperthermia, leaves no doubt in establishing the correct preliminary diagnosis.
Analyzes. The man will also have to undergo several types of tests:
Auxiliary methods. As an auxiliary method, ultrasound of the scrotum is used - sound vibrations help to visualize the presence of a hernia, hydrocele (hydrocele), and a tumor process. The specialist may resort to performing a CT or MRI, but the need for these is quite rare.
Treatment
The main treatment for epididymitis orchiepididymitis is antibiotics.
First of all, the urologist prescribes antibiotic therapy .
To achieve a therapeutic effect, the drug should not be resistant to the causative agent of epididymitis orchioepididymitis, since the treatment performed will be useless.
Therefore, the specialist focuses on the data of bacteriological research. Effective antibiotics are Ceftriaxone, Amikacin, Ceftazidime. The optimal course of administration is 10 days (twice a day).
Further treatment is symptomatic. Hyperthermia is eliminated with the help of antipyretics. The patient must be anesthetized.
Since the disease causes tissue scarring, narrowing of the lumen of the ureter and vas deferens, the urologist prescribes the introduction of lidase and aloe , which prevent the development of these complications. The drugs are administered intramuscularly and subcutaneously.
To achieve a faster recovery, a specialist prescribes physiotherapeutic procedures (a course of at least 10 sessions).
If orchiepididymitis is caused by sexually transmitted diseases, a venereologist is involved in the main treatment - he will prescribe appropriate antibiotics and immunomodulators, taking into account sexually transmitted infections. Treatment will take at least a month. The peculiarity is that the man’s sexual partner will also need to undergo it at the same time.
Surgical treatment is used in extreme cases - when suppuration has a fairly wide range and the likelihood of sepsis is high. The wound is drained, the patient is in a urological hospital, under the supervision of doctors. Starting from the second day after surgery, the man is given dressings using an antiseptic solution. The prognosis is favorable.
Possible complications
Negative consequences and complications of orchiepididymitis:
- Testicular necrosis. The inflamed tissue is destroyed and dies.
- Sepsis is a pathological phenomenon in which bacterial flora moves into the bloodstream and a person dies.
Untreated epididymitis orchioepididymitis provokes loss of testicular function.
Scrotal abscess is an extensive purulent inflammation that causes a constant increase in body temperature, unbearable, paroxysmal pain and an extremely unfavorable general condition of the body. Treatment is only surgical. If you delay surgery, sepsis will occur.- Spread of the inflammatory process to nearby organs and anatomical structures.
- Fournier's gangrene is an extremely detrimental consequence of epididymitis orchioepididymitis. Purulent inflammation covers the scrotum and perineum. Sometimes the anus is involved in the pathological process. The fabric is destroyed, rotting, decomposing. The treatment is very complex, lengthy, and requires constant dressings and the administration of large volumes of medications.
- Infertility. A complication of inflammation of the epididymis develops for several reasons - the testicle produces antibodies against its own germ cells, as a result of which sperm are deprived of fertilizing ability. In addition, they cannot move along the vas deferens, since its lumen is narrowed as a result of inflammation.
If the disease is promptly stopped with antibiotics and appropriate treatment, the likelihood of a negative outcome after orchiepididymitis is practically absent.
Preventive measures
Preventing the development of epididymitis orchiepididymitis involves exercising caution during sports activities or physical activity. It is equally important to avoid hypothermia and promptly seek medical help for viral and infectious diseases.
Perform hygiene procedures daily (see 5 rules of intimate hygiene for men), regularly replace underwear to avoid the development of bacterial infection.
Cleanliness in intimate life will help avoid the development of sexually transmitted infections - for this, a man needs to give up casual sex and use contraception.
Epididymitis orchioepididymitis is a disease that you may never encounter during your life; the main thing is to reconsider your attitude towards your own health and objectively assess the level of possible complications if you refuse timely treatment.
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Source: http://MenQuestions.ru/urologiya/orhoepididimit.html
Orchiepididymitis: causes, symptoms and treatment
Testicular diseases
22.05.2018
15.5 thousand
10.4 thousand
9 min.
The peak incidence of epididymitis orchioepididymitis occurs in men of active sexual age; the pathology poses a threat to the development of infertility. This makes it socially significant. The course of the disease has several forms.
It is important to timely identify and prescribe competent complex therapy, otherwise there is a high risk of complications. Drug treatment is prescribed, and surgery is also used.
Orchiepididymitis is a urological inflammatory disease manifested by damage to the testicles and appendages. Most often, the process is localized only on one side. The prevalence of the pathology is observed mainly among men 15-45 years old.
When symptoms appear, they immediately contact a specialist, as their quality of life is significantly reduced. The patient loses the ability to move fully, wear tight clothing and have sexual activity.
This is due to severe swelling of the scrotal tissue, so any impact on this area causes severe pain.
The incidence rate of orchiepididymitis exceeds 30% in all patients who consult a urologist for genitourinary diseases.
The following forms of orchiepididymitis are distinguished:
- 1. Acute - begins acutely, with timely treatment it lasts no more than 7-10 days. If the patient does not see a doctor on time, the process becomes chronic.
- 2. Chronic - symptoms occur during exacerbations and are periodic. It often causes infertility and can lead to testicular cancer. If left untreated, suppuration and abscess formation develop.
- 3. Abscessive - manifested by purulent inflammation, treated mainly surgically.
Spontaneous abscess formation is unlikely; it must be preceded by chronic inflammation.
Chronic orchiepididymitis in the acute stage
Based on the type of pathogen that provoked the disease, there are:
- 1. Specific orchiepididymitis - caused by Mycobacterium tuberculosis, Treponema pallidum (syphilitic), brucellosis, infections transmitted primarily through sexual contact (gonorrhea, trichomoniasis, chlamydia).
- 2. Nonspecific orchiepididymitis - the causative agents can be opportunistic or pathogenic bacteria (staphylococci, streptococci), viruses.
The cause of the development of nonspecific inflammation can be chronic foci of infection, failure to comply with personal hygiene rules, or even weakened immunity. The clinical course of the disease has a general course for a long time.
Boys under 15 years of age rarely suffer from epididymitis orchioepididymitis. Usually the disease develops as a complication of mumps (mumps), rubella, chickenpox, and measles. In preschool children, pathology is a manifestation of malformations of the intrauterine development of the genitourinary system. Other causes of damage to the testicle and appendages may be:
- hypothermia of the lower extremities, groin - blood vessels spasm, blood supply to the genital organs decreases;
- perineal injuries;
- previous surgical intervention.
Since the disease is rare in children, it is necessary to exclude other pathologies - testicular torsion, cord. They have an acute clinical picture and are often similar in symptoms to epididymitis orchioepididymitis.
The causes of the disease are varied, and the patient is not always able to remember a specific event or action that could trigger the development of the pathological process. In the presence of chronic foci of infection, orchiepididymitis develops acutely against a background of general malaise and poor health.
The main factors that provoke inflammation of the testicles include:
- genital injuries;
- immunodeficiency - orchiepididymitis develops, caused by opportunistic microorganisms (staphylococci), normally they are present in small quantities, but when favorable conditions appear, they begin to actively multiply and lead to an increase in the clinical picture;
- prolonged exposure to the cold, severe colds;
- previous sexually transmitted infections - in this case, the causative agents are chlamydia, trichomonas, mycoplasma, gonococci;
- vascular diseases of the genital organs;
- chronic inflammatory processes of the genitourinary tract - urethritis, cystitis;
- generalization of the inflammatory process in sore throat, syphilis, tuberculosis;
- incorrectly performed catheterization for urological diseases.
In addition to the main pathogenetic causes, there are predisposing factors that contribute to the development of orchiepididymitis. These include a low social standard of living, smoking, alcohol abuse, the presence of chronic diseases of internal organs, employment in hazardous work, systematic overwork, chronic stress and an unbalanced diet.
Each form of the disease has its own specific clinic. Considering that the testicles, due to their physiological characteristics, are located outside the pelvis, they are well visualized.
Immediately after the first symptoms of the disease appear, a man can notice changes with the naked eye.
The affected area is increased in size due to swelling, is painful when pressed, and local redness is detected.
| Form of the disease | Clinical manifestations |
| Spicy |
|
| Chronic |
|
| Abscessive |
|
The symptoms of each form are obvious and should not be ignored. A man needs to urgently seek qualified medical help, as the disease does not go away on its own. It tends to increase in severity and transition to a more severe form with the subsequent development of complications.
In the absence of timely, competent complex therapy, the development of irreversible conditions is possible, some of which are incompatible with life and can lead to death. Among the most dangerous consequences:
- chronicity of the process with constant pain after suffering from acute orchiepididymitis;
- sepsis - entry of the pathogen into the general bloodstream, often in the absence of adequate treatment for a scrotal abscess;
- scrotal abscess - diffuse purulent inflammation of the organs of the scrotum and its skin, with fever, unbearable pain;
- Fournier's gangrene - spread of purulent lesions to the perineum, anal area;
- potency disorders;
- pathology of erectile function;
- secondary infertility due to adhesions in the vas deferens, creating an obstacle to the flow of sperm;
- hydrocele - accumulation of inflammatory fluid between the membranes of the testicle, often due to chlamydial infection;
- involvement of the prostate gland in the process, with the development of prostatitis;
- ascending infection of the bladder, kidneys;
- testicular necrosis;
- cancer of the scrotum, testicle;
- fistulas of the skin of the scrotum.
Fournier's gangrene
All complications of epididymitis orchiepididymitis are considered emergencies and are treated in a specialized surgical hospital.
The patient is under medical supervision for a long time, as there is a risk of death.
A rehabilitation period and dynamic observation are required; a chronic process and irreversible changes that have occurred can lead to re-development of the pathological process.
A urologist is involved in the treatment and diagnosis of orchiepididymitis. After treatment, a detailed survey of the patient is carried out to determine the history of the disease and identify predisposing factors. Afterwards, a clinical minimum of examinations is prescribed.
In a general urine test, leukocytes, red blood cells and protein may appear in large quantities. A blood examination reveals nonspecific signs of inflammation: increased ESR and leukocytes. Additionally, a spermogram and bacteriological cultures of seminal fluid and urine are shown. They help identify the pathogen.
Instrumental methods are important for determining the extent of the lesion. All patients are shown a safe and accessible diagnostic method - ultrasound.
To determine the condition of the vascular bed, Doppler sonography and computed tomography are prescribed. In order to identify the nature of the inflammatory process, a biomaterial (biopsy) is taken and examined under a microscope.
The study is called histology (study of soft tissue) and cytology (microscopy of cells).
For any form of epididymitis orchioepididymitis, a man is shown:
- bed rest;
- a diet with limited spicy and salty foods, a large amount of liquid is recommended;
- use of a suspensor - a bandage to support the scrotum (it should be in an elevated state);
- the use of broad-spectrum antibiotics (ceftriaxone, cefazolin, erythromycin, azithromycin, ofloxacin) until the culture results for the pathogen are obtained, after which specific groups of drugs that show the greatest effectiveness of therapy can be prescribed;
- symptomatic therapy - analgesics (to eliminate pain), antipyretics;
- detoxification therapy - elimination of signs of intoxication.
In each individual case, the doctor selects the necessary therapeutic measures. The disease poses a threat to the patient’s life, so self-medication and neglect of recommendations are extremely dangerous.
All patients are prescribed non-steroidal anti-inflammatory drugs (analgin, paracetamol). They eliminate swelling, reduce pain and temperature.
Diclovit suppositories are used to prevent the transition of the inflammatory process to the prostate. For etiotropic (targeted at a specific pathogen diagnosed based on the results of bacteriological culture) antibiotic therapy, sulfonamides, fluoroquinolones, and cephalosporins are used.
Local treatment is required. The basis is cool compresses on the scrotum to reduce pain and inflammation, applications with balsamic liniment according to Vishnevsky.
It is acceptable to use NSAID-based ointments, which are rubbed topically 1-2 times a day. They should be without heating components, since the flow of blood will only aggravate the inflammatory process.
The selection of drugs is carried out by the attending physician.
After reducing the intensity of the acute process, magnetic therapy, ultrasound, and laser treatment are used.
Surgical treatment has a number of indications, including the ineffectiveness of conservative therapy and the presence of complications. Usually it is carried out only in the presence of the following conditions:
- abscessive orchiepididymitis;
- orchiepididymitis caused by Mycobacterium tuberculosis;
- torsion of the testicle or scrotum;
- massive injuries with rupture of anatomical formations;
- infertility caused by obstruction of the spermatic cord;
- relapse of the process;
- lack of treatment results within 3 days of treatment, especially when the pathological process worsens.
The extent of surgical intervention depends on the severity of the disease. In order to reduce the risk of postoperative complications, surgeons always try to perform the least traumatic approach.
This is possible only in the initial stages of the disease, since if there is a purulent leak or the process spreads to the pelvic organs, general access will be required.
In severe cases, removal of the testicle, often with the epididymis, is indicated.
Abscess formation without complications allows for minimally invasive intervention. Usually, it is punctured in order to free it from purulent contents; instead, a medicinal substance is injected into the cavity.
It helps to avoid re-accumulation of pathological fluid.
An alternative is an operation with the formation of drainage incisions on the body of the testicle, in the area of the abscess, through which the pus is separated independently.
Treatment with folk remedies is possible only with the approval of the attending physician. Some recipes can be harmful because they are not indicated in the acute phase of the disease.
Herbal infusions that can be prepared according to the following recipes are effective::
- 1. Mix 1 tbsp. l. tansy, horsetail, lingonberry leaves, pour 0.5 liters of boiling water. Strain after 30 minutes. When the product has cooled, take 100 ml on an empty stomach.
- 2. Combine 1 tsp. parsley, juniper, dandelion and bearberry, pour 2 cups of boiling water, leave for half an hour. After cooling, strain and drink 1 glass 2 times a day.
- 3. Mix the juice of chestnut flowers and golden mustache, drink 30 drops 2 times a day. Store the composition in the refrigerator.
- 4. Take 1 tbsp. l. sweet clover and celandine, pour 500 ml of hot water. Leave for 30 minutes, strain and drink 1 tbsp. l. 3 times a day.
- 5. Mix 2 tbsp. l. gorichnik and coltsfoot, pour 1 liter of boiling water. After 30 minutes, filter, drink ½ glass 3 times a day.
You can prepare homemade ointment from natural ingredients according to the following recipe:
- 1. Melt 30 g of wax, add the boiled and crushed yolk of one chicken egg and 40 g of sunflower oil.
- 2. Boil for 5-10 minutes.
After cooling, lubricate the affected area 2 times a day.
Source: https://zdravman.com/diseases-testes/orhoepididimit.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.
- 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.
- 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.
Severe pain due to epididymo-orchitis can be relieved with novocaine blockades of the spermatic cord.
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
Orchiepididymitis: causes, signs, symptoms, treatment
Orchiepididymitis is a dangerous male urological disease of infectious etiology, in which the inflammatory process affects the testicle and spreads to its epididymis. In most cases, the disease develops in mature men aged 16 to 40 years (during an active sexual life). But epididymitis orchiodermitis also often develops in elderly patients.
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The disease causes men very severe discomfort and is dangerous for their “male” health. The tissues of the scrotum swell greatly and touching them is very painful, so the man cannot lead a full life or wear normal clothes. If adequate and specialized treatment of the disease is not carried out in a timely manner, it can develop into a chronic form and cause a number of dangerous complications.
Causes
Orchiepididymitis most often develops as a consequence of orchitis and epididymitis. In most clinical situations, acute orchiepididymitis develops on the left, in more rare cases - on the right. This occurs due to the anatomical features of the structure of the genitourinary system in men.
The causes of the disease are quite varied, but most often epididymitis orchiepididymitis develops due to:
- physical injury to the testicles or scrotum;
- reduced immunity;
- hypothermia;
- past infectious and non-infectious diseases (trichomoniasis, mumps, mycoplasmosis, ureaplasmosis, chlamydia, etc.). This is the most common cause of epididymitis orchiitis;
- circulatory disorders in the groin area;
- history of chronic diseases of the genitourinary system – balanoposthitis, cystitis, urethritis;
- orchiepididymitis can develop as a complication from tonsillitis, pneumonia, syphilis, tuberculosis, cryptococcosis;
- incorrectly performed catheterization of the bladder in urological pathologies.
All these reasons and unfavorable factors pose a serious threat to a man’s health. Therefore, it is important to promptly treat diseases and prevent them.
Classification
In medicine, epididymitis orchioepididymitis is classified according to its course:
- acute course;
- chronic course;
- abscessive form.
There is also another classification of the disease, depending on the class of pathogen that caused the inflammation:
- specific orchiepididymitis. The disease develops against the background of tuberculosis, brucellosis, syphilis, etc.;
- nonspecific orchiepididymitis. In most clinical cases, its development is provoked by STIs (sexually transmitted infections). The causative agents can be nonspecific infections and viruses.
Orchiepididymitis - inflammation of the testicle and its epididymis
Acute form
The symptoms of this form are quite specific. Acute orchiepididymitis begins with the appearance of severe pain in the groin area, which forces men to immediately run to a qualified specialist for help.
Symptoms:
- in the area of the affected testicle and epididymis, severe pain occurs, which tends to intensify. May radiate to the groin or perineum. Already in the presence of this symptom, the man goes to the doctor for diagnosis;
- the scrotum becomes painful on palpation, swells, and the folds on it smooth out. The tissues turn red and become shiny;
- upon palpation, compaction of the tissues of the testicle itself is noted;
- body temperature can rise to 38–39 degrees.
If these symptoms appear, most of the stronger sex immediately go to see a doctor, since swelling and pain in the scrotum area prevents them from leading a normal life and causes very severe discomfort.
If the correct treatment for acute epididymitis orchioepididymitis was prescribed in a timely manner, then within a week the disease will be eliminated. But there are also men who, for various reasons, put off going to the urologist.
A delay of even a few days can lead to the acute stage developing into a chronic one.
Chronic form
Symptoms of this form appear periodically. Chronic orchiepididymitis is a common cause of male infertility or testicular cancer, so if the first signs are present, treatment must be started immediately.
Symptoms:
- pain in the inflamed testicle, which is constant or periodic. As a rule, they intensify during human physical activity;
- body temperature can periodically rise to 40 degrees for no apparent reason;
- If the cause of the development of the disease is the tuberculosis bacillus, then fistulas may form on the skin of the scrotum.
If you do not visit a doctor and do not undergo treatment, the chronic form will after some time become abscessive with suppuration. This is the most dangerous condition for health, as it leads to testicular dysfunction, male infertility, tumor formation and testicular infarction. The peak of the disease occurs on the second day after the first symptoms are identified.
Diagnostics
In order to identify the presence of a certain pathology, find out its stage and prescribe the correct treatment plan, it is necessary to carry out diagnostics in an inpatient setting.
The main methods that make it possible to determine the presence of orchiepididymitis are the following:
- UAC;
- OAM;
- urethral smear to determine the presence of urogenital infections;
- urine culture for Mycobacterium tuberculosis;
- culture from the urethra;
- Ultrasound of the scrotum;
- PCR to determine the presence of STDs;
- Wasserman reaction;
- If the doctor suspects the presence of a tumor, a testicular biopsy is performed.
Treatment
Treatment of this disease should begin when its first symptoms have already appeared. The sooner it is started, the more favorable the prognosis will be.
The patient needs to be in the hospital so that doctors can monitor his general condition daily. Strict bed rest is also indicated.
The patient is recommended to wear special swimming trunks to pull the affected testicle upward.
Conservative treatment method
After identifying the causative agent of the disease, the patient is prescribed antibiotic therapy, the action of which will be aimed at eliminating the infection from the body. For treatment, drugs from the following groups are prescribed:
- sulfonamides;
- fluoroquinolones;
- aminoglycosides;
- penicillins;
- cephalosporins.
It is recommended to apply cold compresses to the inflamed testicle. This will help reduce discomfort and relieve inflammation.
After the acute process subsides, patients are advised to undergo physical therapy (magnetic therapy, electrotherapy, ultrasound therapy, laser therapy) to restore normal functioning of the testicle.
Surgical treatment of orchiepididymitis is resorted to in the most difficult cases.
Complications
- complete occlusion of the vas deferens;
- scrotal abscess;
- scrotal fistulas;
- cancerous tumors;
- infertility;
- testicular infarction.
Preventive measures
To eliminate the risk of developing this disease, you should follow a few simple recommendations. Since STIs are a common cause of orchiepididymitis, men are recommended to constantly use condoms. If you have previously suffered an injury to the groin area, you should not hesitate and visit a doctor for diagnosis.
The scrotum must be protected not only from injury, but also from hypothermia. Men are recommended to wear underwear made from natural fabric.
It is also important to promptly treat existing diseases of the genitourinary system in order to prevent the development of complications.
Source: https://SimptoMer.ru/bolezni/muzhskie-zabolevaniya/845-orkhoepididimit-simptomy
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