Inflammation of the epididymis

introduction

The Inflammation of the epididymis will also be Epididymitis called. It occurs mostly in adulthood, especially in patients with Indwelling catheter, on. In rare cases, children under the age of 14 can also be affected. One can acute form epididymitis from one chronic form distinguish. The acute inflammation is the most common disease of the epididymis and represents one emergency of the urology that requires immediate treatment. The chronic form can develop from acute inflammation and last at least 6 weeks. Is the Testicles additionally affected by the inflammation one speaks of a Epididymo orchitis.

causes

The epididymis is usually caused by bacteria rising from an existing urinary tract infection or inflammation of the prostate. Epididymitis can be observed especially in people who wear permanent catheters or if the prostate has been removed (prostatectomy). Typical pathogens in sexually active young men are mainly chlamydia or gonococci, which are transmitted through sexual intercourse. In older patients over 35 years of age, the triggers are mainly gram-negative germs (Escherichia coli, Klebsiella, staphylococci). But not only bacteria can cause epididymitis. Fungi or viruses can also lead to inflammation. In very rare cases, tuberculosis can also be the cause of the inflammation of the epididymis. Manipulation of the prostate, for example through a biopsy, and other interventions in the area of ​​the urinary drainage can also promote the development of epididymitis.

Read more about this in our main article on the subject here Causes of epididymitis or under biopsy

If inflammation of the epididymis is detected in childhood before the onset of puberty, a malformation of the urinary tract must always be ruled out, as this is a common cause. This can, for example, be the presence of urethral valves that close the urethra. Residual urine then accumulates in the bladder, which can trigger an ascending infection and thus also an inflammation of the epididymis. Another malformation would be a wrong opening of the ureter (ureter). Instead of the urinary bladder, the ureter can, for example, open into the man's seminal duct. The boys cannot show any symptoms until puberty, after which they usually develop recurrent inflammation of the epididymis or prostate.

Read more on the subject at: Inflammation of the prostate and what consequences can a chlamydial infection have?

Inflammation of the epididymis after vasectomy

Under the vasectomy one understands the severing of the vas deferens, it concerns one Contraceptive methodwhich is popularly also under sterilization is known. As part of the vasectomy various complications can arise. Most often (in up to 6% of patients) there is one after sterilization Inflammation of the epididymis. The sperm formed can no longer enter the ejaculate after the vas deferens have been severed. Instead, be educated Sperm degraded in the epididymis. If the number of sperm formed is higher than can be disposed of via the epididymis, inflammation can occur.

Symptoms

The inflammation of the epididymis begins with sudden pain in the area of ​​the epididymis, which can radiate into the groin region. The pain can be triggered by pressing and touching the testicle. Typically, the pain is reduced when lifting the testicle (positive Prehn's sign). In addition, there is severe swelling and reddening of the epididymis, which can then only be separated from the testicle with difficulty. The area of ​​the epididymis hurts when touched and when pressure is applied. Furthermore, fever, chills and problems urinating can occur.

Read more on the subject at: Epididymis are swollen - what's behind it?

Chronic inflammation can develop in approximately 15% of the population after an acute inflammation. A permanent, painful swelling of the epididymis forms. Further complications are the formation of an abscess with spread of the inflammation to the testicles (epididymoorchitis) in around 5% of those affected.

Please also read our topic: I recognize epididymitis by these symptoms

An important differential diagnosis in children and young men is the twisting of the testicle around its supplying vessels (testicular torsion). If this is not recognized, the affected testicle may die. In this case, the pain occurs extremely quickly and suddenly, the testicle stands up and there is no decrease in pain when the testicle is lifted (negative Prehn's sign). There is no fever and the urine is normal. Testicular torsion is an emergency that requires immediate treatment.

Read more about this under: Swollen testicles - what's behind it?

diagnosis

The main method of detecting inflammation of the epididymis is Ultrasound of the testicle and the neighboring structures (Sonography). You can see an enlarged epididymis and in the special Doppler ultrasound examination, with which the blood flow can be shown particularly well, an increased blood flow to the epididymis. A Abscess formation or one Twisting of the testicle (Testicular torsion) can already be excluded by ultrasound. In addition, this examination can also be used to monitor the course of the inflammation.

Delivered in one Urine sample there is an increased number white blood cells (leukocytes), the pathogen can rarely be detected in the urine. Pathogen and resistance can be determined by creating a urine culture. This is important to get the right one Antibiotics to be selected for therapy. If the cause is suspected to be a sexually transmitted disease, the pathogen can be caused by a Urethral smear being found.

If, despite all the diagnostic procedures carried out, there is any doubt about the existence of a Epididymitis the testicles and the epididymis must be present to rule out twisting of the testicle (testicular torsion) operational be exposed!

therapy

Used to treat inflammation Antibiotics depending on the pathogen present and the resistance situation. Therapy should be started immediately, so it is important to see a doctor as soon as possible if inflammation is suspected.

Furthermore, pain relievers, such as Diclofenacto help against the pain. If the pain is very severe, a Local anesthetic injected to relieve the pain. Also is bed rest With Elevation of the testicle important until the acute inflammation subsides. Physical exertion and sport should be avoided. Elevation prevents traction pain and facilitates lymphatic drainage. In addition, can also cold envelopes to provide relief to the affected testicle. If the diagnosis is uncertain or if there is no response to the therapy, the testicle may have to undergo a surgery be exposed. This can clean up the wound and split a possibly existing one Abscess respectively.

In children, if the diagnosis is uncertain, the immediate exposure of the testicle can rule out and correct it. If the inflammation does not subside despite treatment or a chronic form may be present surgical removal of the epididymis (Epididymectomy) or a transection of the vas deferens (vasectomy) become necessary. If the testicle is also affected by the inflammation or an abscess has formed, in severe cases it may even be necessary to remove the testicle (Orchiectomy) come.

Therapy with natural remedies, home remedies & homeopathy

A Antibiotic therapy is important and indicated in any case.Herbal and homeopathic remedies can also help to shorten the course of the inflammation or to relieve the pain. For example Moor packs recommended. Also a treatment with Leechesthat are placed on the affected epididymis can provide relief. As homeopathic substances can additionally Aurum preparations are given. Usually Aurum chloratum natronate, Aurum colloidale, Aurum iodatum or Aurum metallicum recommended. These homeopathic substances can be helpful especially for chronic and recurring testicular inflammation in addition to targeted antibiotic therapy. However, attention should be paid to a low dosage and the use of only one preparation.

forecast

The Swelling of the epididymis after the inflammation can persist for a few weeks. With resistance-appropriate Antibiotic therapywhich is matched to the pathogen, the inflammation can be treated well. Young men in particular are advised to see a doctor quickly if they have symptoms about other diseases and dangerous ones Testicular torsion to be able to exclude. A good therapy of the Epididymitis is important so that this does not recur and eventually turns into chronic inflammation. In the chronic form, the gluing of the Vas deferens and associated infertility threaten.