Acute and chronic orchiepididymitis in men - how to treat, consequences

Diseases of the genitourinary system reduce potency, lead to infertility. Orchiepididymitis is an inflammation of the testicle with the epididymis (connects the testicles to the vas deferens), which negatively affects men's health in general. If the disease is not detected in time and treatment is not started, serious complications can occur.

Description

Orchoepididymitis in the international classification of diseases (ICD 10 code) includes two clarifications: with an abscess (code 45.0) and without (code 45.9).

Among patients, unilateral lesions are more common. Bilateral threatens those who have a weak immune system, when inflammatory processes proceed quickly, and the appeal to specialists has been postponed.

The disease is typical for men around the age of 40, but there are exceptions (sometimes observed in adolescents and the elderly).

Causes of epididymitis in men

The disease can be caused by an infection trapped in the testicle in the event of irregularities in the genitourinary system.

Most of the inflammation is caused by the following pathogens:

• chlamydia;
• mycoplasma;
• Trichomonas;
• gonococcus;
• Escherichia coli (most often caught during anal sex).

Orchiepididymitis in men provoke vesiculitis, urethritis, prostatitis, stagnation of blood in the pelvis, hypothermia (including the legs) and perineal injuries that disrupt the blood flow of the scrotum. The reason may be improper bladder catheterization, cystoscopy or other type of instrumental intervention (including surgery), within which a medical error was made.

The defeat of the epididymis with the testicle can occur against the background of influenza, herpes or measles. Sometimes it is also fixed after mumps (mumps).

Symptoms and signs

Orchoepididymitis comes in two forms:

• spicy;
• chronic.

Acute epididymitis orchitis is characterized by severe pain in the affected part of the scrotum. The epididymis is swollen and indurated. Any contact with clothing while walking causes discomfort. The body temperature rises to 39-40 degrees, weakness, sweating, aching bones appear, the man feels "crushed", irritability is inherent in him.

Chronic orchiepididymitis occurs due to the absence, inadequate or incorrect treatment of the acute form. Basically, if a man has a weakened immune system. In simple terms, these are temporary retreats and exacerbations of the disease, continuing for a long time. Symptoms and signs are the same, but only during exacerbations, in remission they are either erased or absent.

Diagnostics

If you suspect orchiepididymitis, if a man is faced with most of the symptoms, you must go to the hospital to see a urologist. The main methods of diagnosis are palpation and feeling, taking anamnesis.

In addition, the patient is prescribed the following tests:

• blood (general, biochemical, tumor markers, such as hCG and PSA, for the Wasserman reaction for the presence of STDs);
• urine (general and culture, if necessary);
• urethral swab and culture

Ultrasound of the scrotum and ureteroscopy are also performed (not always).

It is not difficult for an experienced doctor to detect a disease, it is more difficult to determine the cause due to which the disease has developed.

Types and types

Orchiepididymitis is classified by form (acute and chronic). By type, it can be one-sided (left-sided, right-sided) and two-sided. There are many types, mainly purulent and stagnant are distinguished in medicine.

Acute and Chronic

Acute is characterized by piercing pain in the testicle. The main part of the scrotum is enlarged (2-4 times), becoming smooth and glossy due to smoothing of the skin. Even a slight touch causes discomfort in the inflamed area. The temperature rises, general weakness is observed. Sometimes gagging occurs.

Chronic is considered a complication. The temperature decreases, the pain becomes bearable (during remission), but when palpating the inflamed area, a seal will be felt. The main feature is relapses for a long time (from six months), 1-2 times every 3 months. Difficult to treat, provokes infertility.

Left-handed and right-handed

In medicine, left-sided and right-sided orchiepididymitis are classified. It all depends on which side of the scrotum is the inflammatory process. Most often, the first is found, which is due to the structure of the male genitourinary system, where the appendage on the left is more elongated. Accordingly, it is the left side that is most often affected (in 70% of cases). The right-sided variant is recorded less often, in 25% of cases. Possible bilateral orchiepididymitis (mainly develops from left-sided or right-sided, with delayed treatment).

Festering

Purulent orchiepididymitis is an abscess lesion of the scrotum. It is also called the third form of the disease. Without the use of timely measures, the general condition worsens, the testicle (or both) atrophies, the ability of a man to have children is minimized. If, after this, a visit to a doctor is not followed, infection of other organs and systems of the body with all the ensuing consequences is possible. Self-medication is not allowed.

Stagnant

Congestive epididymitis orchitis appears due to severe circulatory disorders in the pelvic organs. May be the result of a sedentary lifestyle, inactivity, chronic constipation or hemorrhoids, the practice of PPA.

If the doctors could not establish the cause of the occurrence, a diagnosis of "nonspecific epididymitis orchidism" is made.

Treatment

Treatment of orchiepididymitis can be prescribed only taking into account all the patient's complaints, as well as materials from laboratory and instrumental studies. Depending on the course of the disease and the cause of the onset, conservative or surgical treatment is prescribed.

Sometimes folk remedies are used to relieve symptoms. It is also important to follow some tips in parallel (to speed up your recovery).

Medicines

The basis of the treatment of infectious inflammation of the epididymis with the testicle is antibiotic therapy. To stop the inflammatory processes, the doctor prescribes antibiotics, against which the detected pathogen is unstable. Most often these are drugs with a wide spectrum of action:

• Ceftriaxone;
• Azithromycin;
• Ciprofloxacin.

The course of antibiotic use is 7-14 days, the dosage is calculated individually by the attending physician.

To relieve pain and partially relieve inflammation, analgesics (such as Ibuprofen and Ketanov) are prescribed. At high temperatures, antipyretic drugs (Nise, Aspirin, Nurofen) are topical. In parallel, it is important to take vitamin complexes that stimulate the natural production of androgen supplements.

Folk remedies

The disease must be treated with a specialist, medication, however, there are auxiliary folk remedies that reduce symptoms, making life easier for a man. It is important to discuss their application with a professional.

Useful recipes for folk remedies for epididymitis:

• When the scrotum is swollen, a medicinal tea is prepared from verbena and fragrant callisia leaves in a 1: 1 ratio. The ingredients (in the amount of 15 g) are mixed and poured into a glass of boiling water. The broth is wrapped in a scarf and placed in a dark place. After 30 minutes, the product is filtered and ready to use. Drink after breakfast for 15 days.
• Herbal decoction with garlic, lemon and honey will relieve pain. For cooking, you will need 3 fresh leaves of a golden mustache, 5 heads of garlic, juice of 6 lemons, 2 cups of honey. The first 2 ingredients are crushed, then mixed with the rest, set aside in a dark, cool place for a day. Take 3 tablespoons at a time after breakfast, lunch and dinner. Duration - 30 days.
• With the next exacerbation of the chronic form, a drink is taken based on a mixture of celandine and sweet clover. The ingredients are mixed in equal proportions and poured into a glass of boiling water. After half an hour, the drink is filtered. Consume 1 tablespoon after a full meal for 10 days.

Tips

Rest, warmth (semi-alcoholic warming compresses) and novocaine blockade of the spermatic cord are auxiliary means in the treatment. During the course of therapy, it is not recommended to massage the testicles (and, if possible, the prostate gland) and other manipulations with the organ. In this case, it is worth adhering to certain recommendations:

• refrain from sexual intercourse during treatment;
• give up alcohol and smoking;
• tidy up the food;
• don't get hypothermic;
• don't overdo it.

Surgery

Surgical intervention (operation) is prescribed if drug treatment was ineffective, with the rapid development of inflammation, its transition to the last stage. The type of operation is selected in accordance with the degree of neglect and the individual characteristics of the patient.

Specialists perform a puncture of the scrotal cavity, the method of incisions on the head of the epididymis (for opening and draining an abscess), resection of the inflamed part of the organ or its complete removal. It all depends on the defeat. If you need to relieve pain and relieve swelling, a puncture is used. When the organ is completely damaged and the operation does not help, the testicle is removed (together with the epididymis).

Complications and consequences

If you do not start treatment on time, the consequences in the form of complications will not be long in coming:

• testicle failure;
• decreased libido;
• death of testicular tissue due to blockage of blood access to the organ;
• formation of abscesses in the tissue structures of the testicles;
• erectile dysfunction;
• infertility.

Is it possible to have sex while sick?

No. It is recommended to return to sexual activity only after the completion of the course of treatment (and then if it is successful). IMPORTANT: even after recovery, a man should be wise when choosing a partner, and at the same time it is important to use barrier contraception during sex (if there are several girls / women or one that is not unreliable in terms of health). After the operation, sexual rest is recommended for six months.

Features of orchiepididymitis in children

Boys under the age of 16 are rarely diagnosed with epididymitis orchiditis. Most often, the disease in children can be triggered by the pathological development of the genitourinary system or the severe course of mumps, rubella.

Before making a diagnosis, the specialist will rule out other testicular problems (for example, torsion of the spermatic cord / testicle or varicocele).

Prevention

Prevention of orchiepididymitis in men requires adherence to the following guidelines:

• use condoms during sex;
• protect yourself from testicular injury;
• avoid hypothermia (especially in the area of the scrotum and legs);
• not to reduce immunity;
• lead a healthy lifestyle;
• undergo an annual medical examination in order, if necessary, to diagnose and treat STDs and other pathologies of the genitourinary system on time.