Epididymitis
Introduction
Introduction to epididymitis Epididymitis is a common disease in young adults. When the body's resistance is low, pathogenic bacteria such as Escherichia coli, Staphylococcus, and Streptococcus will take the opportunity to enter the vas deferens and invade the epididymis to cause inflammation. Therefore, the disease is divided into acute and chronic epididymitis. Acute epididymitis is caused by urinary system, prostatitis and seminal vesicle spread along the vas deferens to the epididymis. Blood transport infection is rare. Transurethral instrument operation, frequent catheterization, indwelling catheter after prostate removal are easy to cause epididymitis. . basic knowledge The proportion of the disease: the incidence rate in the male population is about 0.1% - 0.2% Susceptible people: male Mode of infection: non-infectious Complications: Prostatitis
Cause
Cause of epididymitis
Disease factor (35%)
Acute epididymitis is caused by urinary system, prostatitis and seminal vesicle spread along the vas deferens to the epididymis. Blood transport infection is rare, and acute epididymitis treatment can not be converted to chronic epididymitis.
Iatrogenic factors (25%)
The disease can be caused by iatrogenic factors, which are inflammations caused by damage caused by medical operations. Such as transurethral instrument operation, frequent catheterization, indwelling catheter after prostate removal are easy to cause epididymitis.
Prevention
Epididymitis prevention
(1) Pay attention to the regularization of life, work and rest, avoid alcohol and tobacco and spicy stimulation.
(2) Keep the stool smooth.
(3) Avoid sedentary for a long time.
(4) Sex life should not be too frequent.
Complication
Epididymitis complications Complications prostatitis seminal vesiculitis
(A) chronic prostatitis chronic prostatitis with urgency, frequent urination, urethra burning pain, urinary effusion white turbidity, perineum, less abdomen, testicular and urethra discomfort or pain as the main clinical manifestations, prostatic fluid leukocytosis , lecithin small body reduction, chronic prostatitis should be treated with both offensive and remedy, combined with comprehensive treatment, as well as attention to life and diet conditioning, help to improve efficacy.
(B) the main clinical manifestations of seminal vesiculitis is blood, accompanied by frequent urination, urgency, urination discomfort, perineal discomfort and other symptoms, often coexist with prostatitis, the main cause of seminal vesiculitis is disease and evil Into the viscera, visceral disorders, qi and blood disharmony, causing damage to the seminal vesicles, blood effusion, Chinese medicine treatment from the "blood" treatment, respectively, "cool blood to stop bleeding", "nourishing blood to stop bleeding", "invigorating The method of blood-seeking and blood-activating and stopping bleeding has a good effect on most patients with seminal vesiculitis.
Symptom
Epididymitis symptoms Common symptoms Scrotal swelling Inguinal pain High fever Scrotum swells swelling and swelling sensation vas deferens thick scrotum swelling and pain Under the abdomen dull pain and soreness inguinal lymphadenopathy
1. Clinical manifestations of acute epididymitis:
Sudden onset, high fever, elevated white blood cells, painful scrotal pain on the affected side, feeling of sinking, pain in the lower abdomen and groin, increased in standing or walking, swollen epididymis on the affected side, obvious tenderness, and a large range of inflammation Both the epididymis and the testis are swollen. The boundary between the two is unclear. It is called epididymal orchitis. The spermatic cord on the affected side is thickened and tender. Under normal circumstances, acute symptoms can gradually subside after one week.
2. Clinical manifestations of chronic epididymitis:
Chronic epididymitis is more common, some patients become chronic due to failure to completely cure in the acute phase, but most patients have no clear acute phase, inflammation is secondary to chronic prostatitis or injury, patients often feel the side of the scrotum hidden pain, Swollen sensation, pain often involves the lower abdomen and ipsilateral groin, sometimes combined with secondary hydrocele, the epididymis often has different degrees of enlargement and hardening, mild tenderness, ipsilateral vas deferens Thicken.
Examine
Epididymitis examination
Laboratory examination: peripheral blood leukocytes can reach (2~3)×10/L. Urethral secretions can be stained or not stained. Urine analysis is also an important means of examination.
Ultrasound examination: Ultrasonography is of great value in the diagnosis of acute epididymitis, especially differential diagnosis. In acute epididymitis, B-ultrasound shows diffuse uniform swelling of the epididymis; it can also be locally enlarged, more common in the tail, nodular, and spherical. The internal echo is uneven, the spot is thickened, the echo intensity is lower than the testicle, and the boundary is blurred. Some can adhere to the scrotum wall, the scrotum wall thickens, often accompanied by hydrocele. The same side of the spermatic cord thickening, varicocele. Color Doppler flow imaging (CDFI) showed a significant increase in blood flow signals, and pulsed Doppler (PD) detected arterial blood flow velocity.
Diagnosis
Diagnosis and identification of epididymitis
TCM diagnosis of epididymitis summary:
(1) Interview: The main complaint is scrotum swelling and pain, and the backache is sleepy. Ask cold and heat at the same time, ask for notes and ask for pain.
(2) cut-off: cut the pulse, check can touch the epididymis to enlarge, harden, with mild tenderness, the affected side of the vas deferens thickening. The epididymis is nodular, with thick and swollen sub-systems, slight tenderness, or traction, less abdominal discomfort, and no systemic symptoms.
(3) Looking around and hearing the diagnosis: Looking for a scrotal enlargement, no special findings were found.
