How to treat epididymal tuberculosis? The difference between Chinese and Western medicine

Some men accidentally find that their epididymis is enlarged or has hard lumps. This is mostly caused by epididymal tuberculosis. Epididymal tuberculosis is very harmful to the health of male reproductive organs. If it is not treated in time, it may lead to problems such as infertility. So, what are the treatments for epididymal tuberculosis?

1: Anti-tuberculosis drug treatment should be started from the beginning. If combined with urinary tract tuberculosis, it should be treated according to the conventional treatment method. If it is only epididymal tuberculosis, the medication time can be slightly shorter. It can be cured in the early stage, but small nodules that cannot completely disappear are often left.

2: Surgery: Patients with large epididymal tuberculosis, nodules larger than 2 cm after anti-tuberculosis drug treatment, cold abscesses or scrotal sinuses, and severe local caseous necrosis with testicular invasion should undergo surgery. Epididymal lesion removal or epididymotomy can be performed. For patients with epididymal tuberculosis on one side and severe prostate lesions that have affected sperm output on the other side and who do not need to have children again, epididymis removal can be performed while the vas deferens on the other side is ligated to reduce the chance of tuberculosis on the other side.

1: 1. Yang deficiency and phlegm stagnation syndrome: chronic enlargement of the epididymis or testis with irregular nodules, thickening of the spermatic cord in the shape of beads, discomfort in the scrotum or a feeling of falling; pale complexion, chills, cold limbs, sore waist and weak knees. Pale tongue, white fur, thin and weak pulse. Treatment: tonify the liver and kidney, warm the meridians and dredge the channels, resolve phlegm and disperse nodules.

2: Prescriptions (1) For those who have not yet ruptured, use Yanghe Decoction (ancient prescription from the Complete Collection of Surgical Symptoms and Treatments). Prescription: 30g of Rehmannia glutinosa, 9g of deer antler glue, 3g of cinnamon powder (taken with water), 2g of ginger charcoal, 6g of white mustard seeds, 2g of ephedra, and 3g of liquorice. Decoction in water, 1 dose per day. (2) After the puncture, use Xiantian Dazao Wan (ancient prescription): 20g of Radix Codonopsis, 9g of Atractylodes macrocephala, 12g of Radix Angelicae Sinensis, 15g of Poria, 15g of Cuscuta australis, 9g of Fructus Lycii, 9g of Polygonatum sibiricum, 9g of Achyranthes bidentata, 10g of Psoralea corylifolia, 10g of Drynariae chinensis, 10g of Morinda officinalis, 6g of Radix Polygoni Multiflori, 6g of Green Salt, 6g of Clove, 20g of Radix Rehmanniae Preparata, 9g of Curculigo orchioides, 20g of Polygonum multiflorum, 10g of Jujube Fruit, 9g of Cistanche deserticola, and 10g of Placenta. Decoction in water twice and take in 2 doses, one dose per day.

3: Chinese patent medicine (1) For patients who have not yet recovered, take Xiaojin Pills orally, 9 grams each time, 3 times a day. (2) For patients who have recovered, take Heche Dazao Pills orally, 9 grams each time, 3 times a day; or Shenrongbu Pills orally, 9 grams each time, 3 times a day.

4: Yin deficiency and phlegm accumulation syndrome: Chronic enlargement of the epididymis or testis with irregular nodules, thickening of the testicles and bead-like appearance, spontaneous swelling and dull pain of the epididymis or testis; flushed cheeks or face, slight fever, fever in the five parts of the body, afternoon hot flashes, insomnia, sweating, fatigue. Red tongue, little coating, weak and rapid pulse. Treatment: tonify kidney yin, reduce deficiency fire, and remove phlegm and dampness.

5: Prescriptions and medicines (1) For those who have not had a seizure, use Ziyin Chushi Decoction (Huang Jitang's "Men's Diseases") Prescription: Chuanxiong 9g, Angelica 12g, White Peony 15g, Rehmannia Glutinosa 20g, Bupleurum 10g, Phellodendron 9g, Perilla frutescens 6g, Anemarrhena 9g, Fritillaria 9g, Herba Lycii 10g, Radix Digupi 9g, Licorice 6g, 3 slices of ginger. Decoction in water, daily dose. (2) For those who have had a seizure, use Zhibai Dihuang Pills (see the prescription for the type of Yin deficiency and excessive fire).

6: Chinese patent medicine (1) Zhibai Dihuang Wan, oral, 9 g each time, 3 times a day. (2) Qiju Dihuang Wan, oral, 9 g each time, 3 times a day. (3) Liuwei Dihuang Wan, oral, 9 g each time, 3 times a day.

Cure, generally no surgical removal is required. If caseous necrosis is severe and drug treatment is ineffective, epididymis removal can be performed. During the operation, the epididymis and its lesion tissue are completely removed, and the vas deferens should be cut as high as possible. The drug treatment of testicular tuberculosis is the same as that of epididymal tuberculosis. The surgical principle is to preserve testicular tissue as much as possible. If the lesion involves most of the testicles, it is no longer worth preserving and orchiectomy can be performed.