Epididymitis is a common disease among young adults. Whenever the body’s resistance is low, pathogenic bacteria such as E. coli, staphylococcus and streptococcus will take advantage of the opportunity to retrograde into the vas deferens and cause inflammation of the epididymis. Therefore, this disease is mostly followed by posterior urethritis, prostatitis and seminal vesiculitis.
Generally, patients with epididymitis will have hard nodes, which mostly occur at the head or tail of the epididymis, mostly at the tail. After epididymal infection, nodes are often left at the tail or head, as shown in the figure.
Acute epididymitis is mostly caused by the spread of urinary prostatitis and seminal vesiculitis along the vas deferens to the epididymis due to bloodstream infection less commonly transurethral instrumentation operation frequent catheterization prostate removal after indwelling urinary catheter, etc. are prone to cause epididymitis, acute epididymitis can turn into chronic epididymitis if treatment is not complete.
The main reason for the external infection is the unreasonable design of the traditional men’s underwear on the market. Most men’s underwear are basically double-layered in front of the design, wrapping the penis and scrotum together, resulting in the penis and scrotum being in a hot and humid environment for a long time, becoming a breeding ground for germs and other microorganisms, which can easily trigger prostatitis and lead to epididymitis, often easily ignored.
Most chronic prostatitis falls into this category, and there is no unified opinion on the causation of this disease. It is a good idea to have a good look at the actual site. The onset of the disease may be related to irregular sexual life, erection without ejaculation, interrupted sexual intercourse or long distance cycling, long sitting work resulting in pelvic congestion by the prostate, etc. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
Another large amount of survey data shows that acute epididymitis may also be caused by external extrusion, with the feeling of the testicles being squeezed. More often than not, the cause is still the result of an overly frequent sex life, especially for teenagers and unmarried people, masturbation may also lead to the occurrence of this disease!
The epididymis function alone is still relatively easy to cure, but while the epididymis is infected, it is usually accompanied by other inflammatory diseases, and it is hard to say whether it can be completely cured in this case. Observations show that the proportion of abnormal epididymal function caused by unclean sex is increasing, and most of the infertile male patients with infected epididymis have revealed that they have had a one-night affair or have been looking for a lady. However, epididymal infection can also be caused by long foreskin and long-term non-cleaning.
Clinically, there are two types of acute epididymitis and chronic epididymitis.
1. Acute epididymitis symptoms.
Sudden high fever with elevated white blood cells, distension and pain in the scrotum on the affected side, sinking sensation, pulling pain in the lower abdomen and groin, and intensifying when standing or walking. The affected epididymis is swollen and has obvious pressure pain. When the inflammation is extensive, both the epididymis and the testis are swollen, and the boundary between them is indistinct to touch, which is called epididymitis orchitis. The spermatic cord on the affected side is thickened and there is also pressure pain. In general, the acute symptoms can gradually subside after a week.
2.Chronic epididymitis symptoms.
Chronic epididymitis is more common, and some patients turn chronic because the acute phase is not completely cured, but most patients do not have a clear acute phase, and the inflammation is mostly secondary to chronic prostatitis or injury. Patients often feel vague pain and swelling in the affected scrotum, and the pain often involves the lower abdomen and the ipsilateral groin, sometimes combined with secondary syringomyelia. On examination, the epididymis is often enlarged and hardened to varying degrees. There is mild pressure pain, and the ipsilateral vas deferens may be thickened.
Treatment methods
1.Special treatment
If the patient is seen within 24 hours of the onset of the disease, infiltration anesthesia of the spermatic cord above the testis with 1% procaine 20ml or lidocaine local anesthetic drug may completely relieve the disease, the body temperature usually drops rapidly, the pain may disappear completely, and the inflammatory mass may be absorbed within a few days, otherwise it usually takes 2~3 weeks to be absorbed. If 1 injection does not completely achieve the goal, another injection may be given the following day.
Antibiotics help in the treatment and secondary cystitis will be cured quickly. Antibiotic selection should be decided by bacterial culture and drug sensitivity test. Commonly used drugs are cotrimoxazole, haloperidol, fluazinic acid and other second and third generation quinolones and cephalosporins, all of which have good efficacy.
2.General treatment
During the acute period (3~4 days), bed rest should be taken. The application of scrotal support can reduce the symptoms. For heavy pain, painkillers can be used. Local heat therapy can relieve the symptoms and promote the inflammation to subside. However, premature use of heat therapy can aggravate the pain and risk the spread of infection, so it is advisable to use ice packs for local cold compresses in the early stages. Sexual life and physical labor can aggravate the infection, so they should be avoided.
Physiotherapy for epididymitis.
Holding up the scrotum, local hot compress, hot water sitz bath, physiotherapy, etc. or direct use of tolvadex can relieve the symptoms. Pay attention to the comprehensive treatment of prostatitis. If the local pain is severe, recurrent, and affects life and work, epididymectomy can be considered.