Urology-Online

Inflammation of the vas deferens

introduction

A Inflammation of the vas deferens (also: deferentitis, vasitis ductus deferentis) rarely occurs in isolation.

The spermatic duct has its origin in Epididymis, runs through the Inguinal canal to bladder and finally flows into the urethra which henceforth runs through the limb as a urinary and seminal duct. Inflammation of the vas deferens is mostly caused by inflammation of the prostate, of Testicle or the epididymis. Because of the common end route is at inflamed vas deferens often that too urethra affected by inflammation.

Classic sexually transmitted diseases can also cause inflammation of the vas deferens.

Both with inflammation of the testicle and the prostate are commonly bacteria the cause. If there is a bacterial infection, it can usually be im Blood or urine be detected. A rather chronic special form occurs in men vasectomy on, but this is usually symptom-free and without further consequences.

causes

As mentioned above, the cause of an inflammation of the spermatic duct is usually not in the spermatic duct itself.

A bacterial infection of the prostate or testicle can arise on the one hand from an ascending infection of the urethra, on the other hand from a washout from the blood. Frequent causes are e.g. E.coli, enterococci, chlamydia, treponemas or mycoplasmas, also the classic pathogens of sexually transmitted diseases.

Read more on the topic: STDs

These usually rise from the urethral opening, after microtrauma, especially during sexual intercourse, through the urinary spermatic duct and thus also lead to infection of the spermatic duct. With frequently changing sexual partners, the risk is increased. Men in puberty and those immediately after a vasectomy are also particularly at risk of developing inflammation of the vas deferens and neighboring structures.

Inflammation of the vas deferens after vasectomy

A special form of inflammation of the vas deferens is the so-called vasitis nodosa. This occurs almost exclusively in men after a vasectomy.

This process in the spermatic duct is usually not noticed by its symptoms, but only when such a vasectomy is to be reversed. In this form of inflammation of the vas deferens, a thickening of the epithelium (skin layer) and the spermatic cord muscles are in the foreground. Sperm granulomas are then deposited in the resulting nodules. These represent a mixture of the sperm, which no longer get outside due to the vasectomy, and inflammatory cells. However, these granulomas have no long-term effects or impairments. This type of inflammation of the spermatic duct does not cause any pain or other symptoms. Mostly young men are affected. As with the other forms of inflammation, the spermatic duct is also thickened here, but it can also be palpated as knotty. This symptom-free disease is only relevant if a vasectomy is to be reversed. If a vasectomy has been performed, this should be kept in mind, as the nodular swelling can initially be mistaken for a tumor.

Read more on the topic: vasectomy

Symptoms

Typical symptoms of inflammation of the spermatic duct are burning sensation when urinating, burning sensation after urination, pain and burning sensation during sexual intercourse, increased urination and whitish discharge, which occurs especially in the morning. In addition, there may be pain in the testicles, in the prostate area, in the pelvic floor and in the groin, depending on the areas affected. In general, however, the symptoms in men usually appear relatively late. In the case of an isolated inflammation of the vas deferens, a feeling of pain occurs in the groin, which can also be associated with swelling. If swelling occurs in the groin area, this can be confused with an inguinal hernia. In the case of long-term inflammations, these are often accompanied by a general feeling of malaise and a feeling of illness.

also read: Swollen testicles - what's behind it?

Pain with inflammation of the vas deferens

An inflammation of the vas deferens is usually painful and very uncomfortable for the person concerned. The pain is not limited to a specific region, but often extends over the entire area of the groin and the genital region. The extent of the pain depends on the cause of the vas deferitis. Depending on whether the prostate, testicles or epididymis are also involved in inflammation, these structures can sometimes be very painful. Because the spermatic duct opens into the urethra, it is very often affected due to its spatial and functional proximity.

The pain is mainly triggered when the affected structures are touched. In this case, the ejaculation is painful because it puts a lot of functional strain on the vas deferens. Because the urethra is also often affected, the pain also manifests itself during and after urination. To relieve the pain, a hot water bottle or a hot shower is recommended after ejaculation or, if necessary, after urination.

If the inflammation only affects the vas deferens, there is usually a diffuse pain in the groin region. This must not be mistaken for a groin problem, for example a hernia.

Further information on this topic can be found at: Spermatic duct pain

Diagnosis

Diagnosing inflammation of the vas deferens primarily includes a thorough physical examination. An inflamed and thus swollen spermatic cord can be palpated, especially in its initial course in the testicle. Above all, however, a differentiation from other causes and a filtering out of accompanying problems, such as the inflammation of the testicles or prostate so very well possible. A further clarification then takes place e.g. by means of ultrasound. A CT can also be used to rule out an inguinal hernia. In addition, urine, blood, smears and prostate secretion can be examined for bacterial infestation in order to confirm the diagnosis and determine the most suitable antibiotic. If the course is severe, the inflammation parameters in the blood can also provide an indication. On the one hand, microscopic diagnostics, i.e. the question of whether immune cells can be found in the urine, play a role in urine. In addition, microbiological cultivation should take place for precise pathogen detection.

Read more on the topic: Sperm ducts swollen - what's behind it?

therapy

In order to treat the inflammation of the vas deferens and the other organs, which are usually also affected, it is important to know the cause. You have the exact one Pathogen a suitable one can be identified antibiotic apply.

In addition, over-the-counter drugs such as ibuprofen can be used to relieve pain and at the same time Inflammatory process contain something. Whether local measures, such as easy Cool or Elevate help of the testicle everyone has to decide for themselves.

In antibiotic therapy, the standard ones usually help Antibiotics, so above all Penicillins, Cephalosporins or Co-trimoxazole. However, the success of the therapy can also be somewhat delayed. This is often the case, for example, when the prostate is also affected. For infections with Chlamydia and mycoplasma are also coming Macrolides or Tetracycline to use. At Trichomonads is Metronidazole the means of choice. In the case of immunocompromised people, a fungal infection should also be excluded as the cause Antifungal drugs, such as. Amphotericin needs treatment.

Antibiotic therapy

A Administration of antibiotics if there is an acute spermatic inflammation almost always essential. Antibiotics work in a targeted manner against bacterial pathogens, causing the inflammation. With the help of Urine samples or Smears A sample of the causative bacteria can be obtained from the inflamed area. With the help of a so-called "Antibiogram“The exact bacterium and the optimal antibiotic are determined. In most cases the standard antibiotics come from the range of Cephalosporins and Penicillins for use.

Depending on how severe the inflammation is and whether the prostate or more Glands with affected, the duration of treatment is different. The therapy should work in a few days to a few weeks. In exceptional cases, a Fungal infection present the not with antibiotics, but with so-called "Antifungal drugs“Is treated. Especially with certain pre-existing conditions or when taking it immunosuppressive drugs, such an infection is possible.

Homeopathic Therapy

With a pronounced Vas deferensitis can homeopathic remedies be taken for pain relief and support. The middle "Pulsatilla pratensis“Is commonly used in men Problems of the genital tract used. An accompanying homeopathic treatment to existing antibiotic therapy can be conducive to healing be. In the case of bacterial inflammation, however, to avoid complications, do not use one antibiotic or anti-inflammatory Therapy should be avoided.

consequences

The consequences and Complications an inflammation of the vas deferens serious be. In general, the disease can be treated well and the pain resolved quickly. With the help of Anti-inflammatories, Pain medication and Antibiotics the inflammation can usually subside without consequences.

However, the spermatic duct inflammation remains untreated or antibiotic therapy fails, it can lead to one chronic course With severe damage come at the spermatic duct. One consequence of this is that infertility. Because of the advanced inflammation it comes to Adhesions and Bonding the soft tissue, so that the function of the vas deferens is restricted. That is also dangerous Spread of infection on the surrounding organs of the genital tract. A Inflammation of the prostate can also be used as long-term consequences Erectile dysfunction and hormonal changes with Loss of libido entail.Inflammation of the testicles and epididymis can also lead to infertility and far-reaching consequences through chronic courses or failure of treatment.

prophylaxis

In order to avoid inflammation of the spermatic duct, as well as all other infections in the genital area, there are two important measures. Firstly, protection against sexually transmitted diseases through the use of a condom. Another important area is hygiene, since infections such as E. coli can get from the anus to the urethra if there is insufficient hygiene. In addition, a lack of hygiene in the area of the urethral opening promotes the rise of the pathogen that has got there. Emptying your bladder as soon as possible after sex can help prevent infection.

forecast

The prognosis for inflammation of the vas deferens is very good. As a rule, inflammation of the spermatic duct can be treated well, so that no permanent damage stay back. A Vasitis nodosa After vasectomy it does not recede, but it does not result in symptoms or any restrictions.