What is Epididymitis ?
Inflammation of the Epididymis is called Epididymitis. Signs, symptoms, causes, complications and management will be discussed here. Acute epididymitis usually lasts up to six weeks and chronic epididymitis lasts more than six weeks duration. In adults it may be caused by sexually transmitted infections (STI) and in children it may be caused by direct trauma or urinary tract infection (UTI).
What is Epididymis ?
Epididymis is a compacted coiled tube situated posterior-lateral to each testes. It has head, body and tail. The length of epididymis is 6 to 7 cm, but if uncoiled it would measure 6 meter. Epididymis is connected to Vas deference and these two comprises of duct system of male reproductive organ.
Function of Epididymis ?
Epididymis is responsible for storage and transportation of sperm cells. When sperm cells are produced in testes they are not fully matured. Epididymis stores sperm cells till maturation. During sexual activity, contractions force the sperm to move into the vas deferens.
Who suffer from Epididymitis ?
Epididymitis can occur at any age. But most common during 14 to 35 years of life.
Predisposing factors are :
Bladder catheterization, urinary tract surgery, circumcision, tuberculosis, structural anomaly of urinary tract, enlarged prostate, unprotected sex, side effect of Amiodarone (a cardiac medicine at dosage above 200 mg).
What are the clinical features of Epididymitis ?
Gradual onset of painful swelling with warmth & redness on one side of scrotum. Fever with chill.
Dysuria, frequency or urgency. Pain and tenderness on testicle. Painful ejaculation & sexual intercourse. Blood in semen. Enlarged lymph nodes on groin. Abnormal urethral discharge.
Complications of Epididymitis :
Infertility, Fistula on scrotum. Shrinkage of Testicle
Differential diagnosis :
Testicular torsion is a very urgent condition due to twisting of spermatic cord.
Causative factors for Epididymitis :
Sexually transmitted infections like Gonorrhoea or Chalmydia.
Urinary tract infection.
Rare causes may be tuberculosis, mumps, Behcet’s disease, prostateomegaly, groin injury, Amiodarone therapy.
Physical examination including rectal examination to see for enlarged prostate. Laboratory test of blood for CBC, VDRL. Urine RE & culture sensitivity. Mantoux test. Chest skiagram. Ultrasonograpghy of Genito-urinary tract.
TREATMENT OF EPIDIDYMYTIS :
Treatment of complications (if any)