Prostate Infection Symptoms: Epididymitis | Causes | Mode of Infection | Treatment | Epididymo-orchitis
What is Epididymitis Infection?
Inflammation of the epididymis is known as epididymitis. Epididymis is the region of coiled segment placed inside the scrotum at the backside of the testis.
When the inflammation spreads to testis it is known as epididymo-orchitis.
Mode of prostate infection of Epididymitis:
Infection reaches epididymis via the lumen of the vas and affects the globus minor first.
It is secondary infection of the urethra, prostate and seminal vesicles.
Blood borne infections affect the globus major of the testis primarily.
Causes of Epididymitis
- Acute epididymitis- Caused due to E. coli, streptococci, staphylococcus or pneumococcus which are common clinical entity. Especially E. coli infection, it is sometimes unaccompanied by infection of the urine (a mid-stream specimen must be sent for bacteriological examination).In the absence of any local cause, the infection is assumed to be blood-borne.
- Instrumental acute epididymitis- Can follow any form of urethral instrumentation. It is most liable to occur when a catheter is tied into the urethra without the necessary aseptic precautions.
- Epididymitis complicating non-gonococcal urethritis- More frequent than it is in gonorrhea and unless correct early antibiotic therapy is given, suppuration is usual.
- Acute gonococcal epididymitis- Much less common than formerly, as a result of the antibiotic treatment of acute gonorrhea. Epididymitis usually commences during 2nd or 3rd week of gonococcal posterior urethritis. In 90% of cases the infection is unilateral.
- Epididymitis from retrograde passage of urine- Epididymitis can develop during an unusual exertion or violent strain while the bladder is full and it is caused by urine being forced along the vas deferens. The degree of inflammation that results depends upon whether the urine is infected or if there is any active or latent infection in the prostate or seminal vesicles. This reflux epididymitis can occur also due to the presence of stricture.
- Acute tubercular epididymitis- When the vas deferens is thickened and the infection does not respond to usual treatment, there is possibility of the infection being due to tuberculosis. Chronic tuberculosis is caused if acute tubercular epididymitis is not treated properly.
- Acute epididymo-orchitis of mumps develops in about 18% of males suffering from mumps.
Clinical features of Epididymitis Infection
The initial symptoms are those of acute prostatitis.
Some days later an ache in the groin with some increase in fever heralds the onset of epididymitis.
Severe pain and swelling of the testis occurs rapidly making the scrotal wall red, edematous and shiny.
The epididymis may become adherent to the scrotal skin and may soften and later discharge.
Resolution is heralded by scaling of the scrotal skin.
Treatment for Prostate Infection Epididymitis
The person must be kept in bed until the acute symptoms have abated.
A broad spectrum antibiotic such as tetracycline should be given until the result of the urine culture is available.
The scrotum is supported on sling formed by broad adhesive plaster attached across the thighs. Upon the sling is placed a nest of cotton wool and in this the inflamed organ rests and cooling lotions are applied.
The urine is rendered alkaline and a high fluid intake is necessary.
Antibiotic therapy is continued for 2 weeks or until inflammation has subsided.
If suppuration occurs, surgical drainage is necessary.
Chronic tuberculous epididymitis requires antibiotic or associated anti-tuberculous drugs.
If there is no sign of resolution in two months, epididymectomy or orchiectomy is advisable.
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