Epididymite – inflammatory defeat of an appendage of a small egg. It is characterized by the sharp beginning, rise in body temperature to 39-40 degrees. There is pain and hypostasis in a scrotum from defeat, increase in an appendage of a small egg several times, reddening of skin of a scrotum. It is often combined with an inflammation of the small egg (orkhoepididimit). Bilateral defeat of appendages, a chronic form of an epididymite, impassability of a semyavynosyashchy stream, infertility can develop. As a rule, concerning an epididymite urologists carry out out-patient treatment, hospitalization is necessary only in case of development of complications. At a sharp epididymite the bed rest, antibacterial and local treatment is necessary; suppuration is the indication for surgical opening and drainage of an abscess.
Epididymite – an inflammatory disease of an appendage of a small egg. As a rule, the epididymite is a complication of a chronic inflammatory disease of bodies of urinogenital system (a vezikulit, prostatitis, an uretrit). In certain cases the epididymite arises at the general infectious diseases (quinsy, pneumonia, flu, etc.). The probability of development of an epididymite increases at injuries of a basin, a crotch and a scrotum, and also existence of other factors promoting stagnation of blood in a small pelvis. The epididymite can proceed sharply or chronically though sharp inflammatory process in the field of a small egg appendage is more often observed.
The last researches in the field of urology showed that sometimes the epididymite develops after sterilization (removals or bandagings of semyavynosyashchy channels). It occurs owing to accumulation of spermatozoa which come to appendages from testicles and do not manage to resolve with a necessary speed.
- Clinical picture of a sharp epididymite
The hyperthermia to 39-40 °C, the sharp pains in the field of a small egg amplifying at the movement, hypostasis and hyperaemia of a scrotum from defeat is characteristic of a sharp epididymite. Pains at an epididymite can irradiate in a crotch, a groin, sometimes – in a waist and a sacrum. At an epididymite combination with orkhity and periorkhoepididimity (an exudate in the field of a small egg) bodies of a scrotum cease to konturirovatsya.
Without treatment of the phenomenon of a sharp epididymite abate in 2-5 days. In a body or a tail of an appendage after the postponed epididymite non-uniform infiltrate of a dense consistence which is quite often replaced with a hem subsequently is formed. Scarring and an autoaggression to own spermatozoa become the infertility reason after the postponed sharp epididymite. Sometimes at an epididymite the semyavynosyashchy channel is involved in process (deferentit) or all seed (funikulit). In the first case the semyavynosyashchy channel is palpatorno defined how a painful dense cord. In the second existence of a painful tyazh thickness about a finger comes to light. For an epididymite of a gonorrheal etiology typically subsharp or torpedo current.
- Clinical picture of a chronic epididymite
The chronic epididymite is the result of sharp inflammatory process of an appendage of a small egg. At a chronic epididymite in a stage of remission of the patient does not feel unpleasant feelings. At an aggravation the feeling of discomfort in the field of a scrotum appears. Numerous inflammations lead to fibrous regeneration of an appendage which quite often is followed by scarring and obstruction of a semyavynosyashchy channel. Palpatorno at the patient decides on a chronic epididymite consolidation, sometimes – increase in an appendage of a small egg. Quite often the thickening of a seed kanatik and increase in diameter of a semyavynosyashchy channel comes to light. Decline in the ability of sperm to fertilization and cicatricial changes at a chronic epididymite can become the infertility reason.
The sharp epididymite in the absence of timely treatment can be complicated by small egg appendage suppuration. At formation of the purulent center the condition of the patient sharply worsens, the hyperthermia and the phenomena of the general intoxication accrues. Scrotum skin at a purulent epididymite becomes smooth, glossy, sharply painful. Distribution of an inflammation on a small egg leads to development of a sharp orkhit. At a chronic epididymite fabric of an appendage is gradually replaced with connecting fabric. Scarring causes obturatsionny impassability of an appendage of a small egg and becomes the infertility reason at patients with a bilateral epididymite.
Treatment of an epididymite
The uncomplicated sharp epididymite is treated by the urologist on an outpatient basis. Hospitalization is shown at threat of development of complications. The patient with a sharp epididymite is transferred to a high bed rest. It is necessary to provide to a scrotum rest and sublime situation (use suspenzoriya or stack a scrotum on the curtailed towel). Exclude fried and spicy food from a diet of the patient with an epididymite. Locally appoint cold compresses to a scrotum lasting from 1 to 2 watch with breaks not less than half an hour.
Therapy of the main disease which became the reason of development of an epididymite is carried out. To the patient appoint antibacterial and rassasyvayushchy medicines, enzymes and vitamins. After elimination of sharp inflammatory process the physical therapy is recommended. Suppuration of an appendage of a small egg is the indication to expeditious treatment – opening and drainage of an abscess. In hard cases removal of an appendage is made.
Therapy of a chronic epididymite in many respects coincides with treatment of sharp inflammatory process in a small egg appendage. At a chronic epididymite more attention is paid to physiotherapeutic procedures and local treatment. At development of complications and inefficiency of conservative treatment carry out an epididimektomiya (removal of an appendage of a small egg).
Prevention of an epididymite
The preventive actions directed to the prevention of development of an epididymite consist in timely therapy of chronic inflammatory diseases of bodies of urinogenital system. Early detection of an epididymite is promoted by observation of the patient of the state after the postponed general infectious disease.