Andrology - male diseases >>>> Orchoepididymitis

Orchoepididymitis.

Male sex glands - testes and their appendages often become participants in the inflammatory process. Inflammation of these organs is dangerous because the reproductive function of these organs may be impaired, since sperm cells are formed in the testicles, and sperm cells ripen in their appendages. When the inflammatory process affects the testicle area, the disease is called "orchitis". If the epididymis is involved in the inflammatory process, then they speak of "epididymitis". When the inflammatory process spreads to both organs, the disease is called "orchiepididymitis".

The causes of orchiepididymitis, orchitis or epididymitis are identical:

Penile trauma (testicles, scrotum), perineal trauma;
Diseases of a non-infectious and infectious nature (mumps, chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis);
Hypothermia;
Sudden changes in temperature conditions;
Complication of tonsillitis, flu, pneumonia, tuberculosis, syphilis, brucellosis, cryptococcosis;
Operations on the pelvic organs;
Injuries during instrumental examinations;
Catheterization for diseases of the urinary tract;
Circulatory disorders;
Lowered immunity;
Chronic diseases of the genitourinary system (urethritis, cystitis, balanoposthitis, prostatitis).

Signs of orchiepididymitis (orchitis or epididymitis):

Pain in the scrotum that gets worse during movement;
Pain can be associated with pain in the abdomen, lower back;
The skin of the scrotum is stretched and reddened;
Change in the size of the testicles and their appendages due to edema (the testicles can increase in size by two to three times);
Compaction of testicular tissue on palpation;
Hyperemia in the testicular area;
Soreness when urinating;
Sometimes hydrocele (reactive dropsy) of the testicle is observed;
An increase in temperature to subfebrile (37) and higher.

The inflammatory process in epididymitis orchitis (orchitis, epididymitis) can be unilateral and bilateral. In the chronic course of orchiepididymitis, an increase in temperature may not be observed, and the edema and compaction of the testicular tissue is much less than in acute epididymitis orchitis.

Diagnosis of orchiepididymitis is carried out on the basis of a visual examination, blood test data, a smear from the urethra. Differential diagnosis of orchiepididymitis with testicular cancer, tuberculous epididymitis, brucellosis testicular lesions, inguinal hernia should be carried out. An ultrasound scan of the scrotum is performed.

Treatment of orchiepididymitis (orchitis, epididymitis) is carried out by a urologist (andrologist) and a venereologist (if the cause of orchiepididymitis is an infectious disease of the genital area). Treatment should be started in a timely manner to prevent complications of epididymitis (testicular sclerosis, testicular abscess, epididymal abscess testicular gangrene, infertility, testicular atrophy).

Treatment of orchiepididymitis pursues several goals, according to which therapy is carried out:

Identification and elimination (elimination) of an infectious agent from the body. In this case, sowing is carried out to clarify the microflora that caused the inflammation, and antimicrobial therapy with broad-spectrum antibiotics (fluoroquinols, macrolides) is prescribed in the case of a bacterial infection, trichopolum is used to destroy the protozoal infection (in the case of sowing). In case of high temperature, antipyretic therapy is performed.
Removal of the inflammatory process and pain syndrome by using anti-inflammatory drugs (diclofenac), absorbable agents (aloe, lidase) to reduce the focus of inflammation, cooling compresses and analgesics (if it is impossible to remove the pain syndrome using conventional methods, blockade of the spermatic canal - the introduction of an anesthetic solution). Since the inflammatory process, as a rule, is accompanied by impaired blood circulation, it is recommended to use venotonics. To detoxify the body, it is necessary to consume a large amount of fluids.
General strengthening agents (vitamins) are prescribed , a course of immunostimulating therapy is carried out .
Restoration of organ functions through physiotherapy (ultrasound, UHF).

Surgical treatment (removal of the testicle) is carried out with a neglected process that led to testicular gangrene.

At the time of treatment, bed or semi-bed rest is indicated, while walking - supporting bandages. Orchiepididymitis is usually experienced at home, but with acute inflammation, hospitalization is possible.

When treating orchiepididymitis of an infectious origin, the health status of the sexual partner should also be taken into account, since infectious pathogens are sexually transmitted.