(1) 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, and the epididymis may be thickened and enlarged, with or without Tenderness, palpation can easily distinguish the epididymis from the testicles, the spermatic cord is often thickened, and sometimes the diameter of the vas deferens is increased. Regular use of patented diuretic and anti-inflammatory drugs will cause the prostate to become hard and fibrotic, and pus cells can often be seen in the prostatic fluid. Urinalysis can reveal Infection secondary to prostatitis is indicated.
Tuberculous epididymitis is very similar to chronic epididymitis. The vas deferens is beaded and the seminal vesicles are thickened. The urine test shows "sterile urine" or "tuberculous bacteriuria", which can indicate that it is Tuberculous epididymitis, bladder ulcers can be seen on cystoscopy, and urinary tract X-ray examination can also help in the diagnosis. Testicular tumors may include testicular masses, and thickening and hardening of the epididymis and testicular (tumor) with reduced sensation may be found on palpation. Epididymal tumors are rare, and differentiation from epididymitis depends on pathology. If chronic epididymitis is bilateral, it can lead to infertility.
(2) The treatment effect of antibiotics alone is often unsatisfactory, and prostatitis must be controlled. If prostatitis is caused by recurrent epididymitis, vasectomy should be performed during the non-attack period. Prostatitis can be cured, and sometimes Epididymectomy is possible.
Clinically it is divided into two categories: acute epididymitis and chronic epididymitis.
Acute epididymitis has an acute onset, manifesting as scrotal swelling and discomfort on the affected side, severe local pain, and even affecting movement. The pain can radiate to the ipsilateral groin area and lower abdomen, accompanied by general malaise and high fever. Physical examination: The epididymis on the affected side is swollen and tender. When the inflammation is severe, it can spread to the testicles, and the skin of the scrotum can become red and swollen.
Chronic epididymitis is more common than acute epididymitis. Some patients cannot be cured in the acute stage and become chronic.
Most patients have no history of acute attacks and are often accompanied by chronic prostatitis. The clinical manifestations of this disease are diverse, including scrotal pain and swelling, and the pain can radiate to the lower abdomen and the inner thigh on the same side. Physical examination shows mild swelling of the epididymis, hardening and induration, local mild tenderness, and thickening of the ipsilateral ureter. Chronic epididymitis often causes acute attacks.
What are the Western medical treatments for epididymitis? Because epididymitis can be divided into acute and chronic conditions, the treatment also focuses on it.