What are the treatments for epididymitis?

Epididymitis is a disease that easily occurs in young men. The main reason is infection with bacteria such as E. coli or Staphylococcus. Once infected with these bacteria, the number of white blood cells in the patient's body will increase, there will be pain in the upper abdomen, which is especially painful when walking, and the scrotum will feel bloated. For this inflammation, the most important thing is timely treatment. Common treatment methods are as follows.

First, treatment

Traditional treatments for orchitis include antibiotics, analgesics, and surgical drainage. Each of these methods has its own advantages and disadvantages:

On the one hand, antibiotics and analgesics can only relieve temporary pain, treating the symptoms but not the root cause, and the effects are not immediate. Moreover, long-term use will cause pathogenic bacteria to develop drug resistance and have serious side effects.

On the other hand, since the disease often coexists with urethritis and prostatitis, which are difficult to treat infectious diseases, the difficulty of treating orchitis is directly increased. Especially for those who suffer from chronic orchitis repeatedly, sometimes they have to undergo vasectomy or orchiectomy, which brings great harm to the patients.

Second, Western medicine treatment

Because epididymitis can be acute or chronic, the treatment also has different emphases. For acute epididymitis, patients are advised to rest in bed and hold up the scrotum to relieve pain. In the early stage, ice packs can be placed on the epididymis to prevent swelling. In the late stage, hot compresses can be used to promote local blood circulation and accelerate the disappearance of inflammation. Because it is an infection, anti-infection treatment should be carried out. In clinical practice, broad-spectrum antibiotics and antibiotics with better effects on Gram-negative bacteria are often used. For systemic symptoms such as pain and fever, antipyretic analgesics should be used to treat the symptoms. If the epididymal pain is severe, a specialist can be asked to give 10 to 20 ml of 1% lidocaine to perform local spermatic cord closure at the upper end of the testicle, which can relieve pain and relieve swelling. If the epididymal inflammatory mass increases in size, the scrotal skin becomes red, swollen and wavy, and abscesses form, incision and drainage must be performed. If the disease is caused by an indwelling urinary catheter, the catheter should be removed. In addition, sexual impulses and heavy physical activities should be avoided during the acute phase to avoid aggravating the infection and symptoms. For a small number of stubborn patients whose condition is not well controlled, epididymectomy or even orchiectomy can be performed.

Because chronic epididymitis often coexists with chronic prostatitis, both diseases are treated together.

If chronic epididymitis recurs multiple times, epididymectomy may be considered. It is worth noting that whether it is acute or chronic epididymitis, if it occurs bilaterally, it may lead to infertility, so epididymitis should be treated promptly.

Third, Chinese medicine treatment

During the acute attack period of acute epididymitis and chronic epididymitis, Wuwei Xiaodu Drink and other prescriptions can be used for treatment according to symptoms.

The prescription of Wuwei Xiaoduyin is composed of 15g honeysuckle, 30g wild chrysanthemum, 15g dandelion, 30g Viola yedoensis, and 10g Gynura odoratum. It is decocted in water and taken orally. For patients with high fever, 60g of gypsum and 30g of Isatis indigotica can be added. For patients with severe heat toxicity, it can be used in combination with Huanglian Jiedutang prescription with modifications.

Chronic epididymitis is a common disease of the male reproductive system. Due to the complex etiology and pathology, the use of antibiotics alone is often not ideal. Most patients are unwilling to undergo surgery or are not suitable for surgery, and Western medicine has no good treatment options.

The basic prescription is composed of 20g Polygonum cuspidatum, 10g Prunella vulgaris, 10g Radix Dioscoreae, 10g Frankincense, 10g Myrrh, 10g Chuanxiong, 10g White Peony Root, 10g Peach Kernel, 10g Angelicae Sinensis. If the tongue is red with yellow and greasy fur, and the pulse is slippery or rapid, add 10g talcum powder, 10g Dianthus superbus, and 10g Honeysuckle. If the kidney yin is insufficient, remove Dioscorea and Prunella vulgaris from the original prescription, add 20g Rehmannia glutinosa, 10g Dendrobium officinale, and 10g Suduan. Take one dose per day, twice a day, 150 ml each time. Boil 500 ml of the residue for local application and wash, combined with local physical therapy. One course of treatment is 10 days, and 3 to 6 courses are observed. According to clinical observations and statistics from the Urology Department of the Guang'anmen Hospital, Academia Sinica, the total effective rate is 92.6%, and the average course of treatment is 3.2.

Explanation of the prescription: Chronic epididymitis can be classified as a type of urethritis or stranguria in traditional Chinese medicine according to its symptoms. Its manifestations include swelling of the scrotum, fixed pain, and local fibrosis, which are signs of blood stasis in traditional Chinese medicine. Since the liver is connected to the genitals, blood stasis in the liver meridian is the pathogenesis of this disease. Epididymitis soup uses Polygonum cuspidatum to promote blood circulation and dissipate blood stasis, clear away heat and detoxify, and is supplemented with frankincense, myrrh, Chuanxiong, and peach kernel to promote blood circulation to improve local blood circulation in the epididymis. Angelica sinensis is selected to promote blood circulation without hurting the body, Prunella vulgaris and Radix Polygoni Multiflori are used to clear heat and detoxify, soften and disperse lumps, and white peony root nourishes and softens the liver. All the herbs are used together to achieve the functions of detoxification, promoting blood circulation, softening and dispersing lumps. Modern pharmacological studies have shown that Polygonum cuspidatum, frankincense, and myrrh have analgesic effects and can relieve scrotal pain and discomfort. Peach kernel and Chuanxiong have anticoagulant effects and can enhance local blood circulation in the epididymis. Antibacterial tests have shown that Polygonum cuspidatum, Prunella vulgaris, and Herba Dioscoreae have different degrees of inhibitory effects on Staphylococcus aureus, Escherichia coli, and Proteus. Clinical practice has shown that the traditional Chinese medicine Diuretic and Anti-inflammatory Pill has a unique therapeutic effect in the treatment of chronic epididymitis, and is safe, efficient, has no side effects, and has a low recurrence rate.