Recurrence of epididymitis

The testicles are a unique male sexual organ. They are very fragile and can easily be infected by bacteria and viruses. If you have a promiscuous sex life and have many sexual partners, you are likely to get epididymitis. This disease can be divided into chronic and acute. If it is not treated in time, it will recur, causing ulceration and pus discharge. You can use a cleaning solution to sterilize and disinfect before going to bed every day, and then apply some ointment to effectively relieve the symptoms.

Chronic epididymitis

Chronic epididymitis is the irreversible end stage of severe acute epididymitis, which often presents milder symptoms than acute epididymitis. Chronic epididymitis causes sclerosis of the entire epididymis due to fibrosis, and scars are very obvious under a microscope. It is common to see obstruction of the epididymal duct, and the tissue is infiltrated by lymphocytes and plasma cells.

(I) Symptoms Chronic epididymitis is usually asymptomatic unless there is an acute attack, in which case local discomfort may occur. The patient may feel a mass in the scrotum. The epididymis is thickened and enlarged, with or without tenderness. The epididymis can be easily distinguished from the testis by palpation. The spermatic cord is often thickened, and sometimes the diameter of the vas deferens is enlarged. The prostate becomes hard and fibrotic. Pus cells are often seen in the prostatic fluid. Urinalysis can show infection secondary to prostatitis.

Tuberculous epididymitis is very similar to chronic epididymitis. The vas deferens is beaded, and the seminal vesicle is thickened. The urine test is "sterile urine" or "tuberculous urine", which can indicate tuberculous epididymitis. Cystoscopy can show bladder ulcers, and urinary tract X-ray examination can also help with diagnosis. Testicular tumors may have testicular masses. Palpation can reveal thickened and hardened epididymis and regressed testicles (tumors). Epididymal tumors are rare, and differentiation from epididymitis requires pathology. If chronic epididymitis is bilateral, it can lead to infertility.

(ii) Treatment: Antibiotics alone are often unsatisfactory in treatment effect. Prostatitis must be controlled. If recurrent epididymitis causes prostatitis, vasectomy should be performed during the non-attack period. Prostatitis can be cured, and epididymectomy can sometimes be performed.

(III) Prognosis

Apart from pain and the possibility of infertility due to bilateral epididymitis, chronic epididymitis has no serious consequences and once it reaches the fibrosis stage, it cannot be reversed.

How many types of epididymitis are there and what are the characteristics of their clinical manifestations?

Epididymitis is a common disease among young and middle-aged men. It is caused by pathogenic bacteria such as E. coli, Staphylococcus or Streptococcus entering the epididymis retrogradely through the vas deferens. Therefore, this disease often occurs secondary to posterior urethritis, prostatitis and seminal vesiculitis, or occurs after urethral instrumentation or long-term indwelling catheterization, and infection is more common in retrograde routes.