What is Epididymitis - Causes, Symptoms, Diagnosis, and Treatment

What is epididymitis?

Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Although males of any age can develop epididymitis, it occurs most frequently between ages of 20 to 39. When it develops in children, it is usually due to inflammation caused by trauma. However, some children develop it because of bacterial infections, some of which may be due to sexual abuse.

 

What are epididymitis causes?
The cause of epididymitis is usually a bacterial infection. The bacteria usually get to the epididymis by moving back through (retrograde) the urethra, prostate, vas deferens into the epididymis. The responsible bacteria are usually identified in about 80% of cases.

Two main groups of organisms cause most cases of epididymitis: sexually transmitted organisms and coliforms (organisms that commonly live in the intestines).

- In men younger than about 39 years of age, the causes are usually the same organisms that cause the sexually transmitted diseases of chlamydia (responsible for nearly 50%-60% of cases) and gonorrhea. The bacterial species are Chlamydia trachomatis and Neisseria gonorrhea, respectively.

- In those older than 39 years of age, the causes are usually coliforms, which are bacteria (such as Escherichia coli) that live in the intestines. These organisms also frequently cause bladder infections. Any age of men who participate in anal intercourse are more likely to get infected with E. coli or other fecal bacteria. Epididymitis is rarely caused by fungi or Mycobacterium spp.

- Chemical epididymitis (rare) is inflammation caused by the retrograde (backward) flow of urine when exercising or having sex with a full bladder.

- Amiodarone (Nexterone), a frequently used heart medication, occasionally causes inflammation of the epididymis.

- Viral infections (including mumps), mainly in the pediatric population.

What are dpididymitis symptoms?

Epididymitis symptoms depend on the cause. They can include:
- A tender, swollen, red or warm scrotum
- Testicle pain and tenderness, usually on one side — the pain may get worse when you have a bowel movement
- Painful urination or an urgent or frequent need to urinate
- Painful intercourse or ejaculation
- Chills and a fever
- A lump on the testicle
- Enlarged lymph nodes in the groin (inguinal nodes)
- Pain or discomfort in the lower abdomen or pelvic area
- Discharge from the penis
- Blood in the semen

Chronic epididymitis

Signs and symptoms of epididymitis usually develop over a day or two and get better with treatment. In some cases, epididymitis may not clear up completely or may recur. This is known as chronic epididymitis. Symptoms of chronic epididymitis may come on gradually. Sometimes the cause of chronic epididymitis is not identified.

How is epididymitis diagnosed?

Your doctor will do a physical exam, which may reveal enlarged lymph nodes in your groin and an enlarged testicle on the affected side. Your doctor also may do a rectal examination to check for prostate enlargement or tenderness and order blood and urine tests to check for infection and other abnormalities.

Other tests your doctor might order include:

Sexually transmitted infection (STI) screening. This involves obtaining a sample of discharge from your urethra. Your doctor may insert a narrow swab into the end of your penis to obtain the sample, which is then tested for the presence of bacteria or other infectious organisms. The results can be used to select the most effective antibiotic for treatment.

Ultrasound imaging. This noninvasive test uses high-frequency sound waves to create images of structures inside your body and is used to rule out conditions, such as twisting of the spermatic cord (testicular torsion) or a testicular tumor. Your doctor may use this test if your symptoms began with sudden, severe pain and other tests have not been definitive.

Nuclear scan of the testicles. Also used to rule out testicular torsion, this test involves injecting trace amounts of radioactive material into your bloodstream. Special cameras then can detect areas in your testicles that receive less blood flow, indicating torsion, or more blood flow, supporting the diagnosis of epididymitis.

How is epidiymitis treated?

The health care practitioner likely will treat the individual with antibiotics through an IV, a shot, or pills orally (to be taken for 10 days or longer). Often the treatment depends on the identity of the infecting bacteria; many physicians elect to treat with at least two different antibiotics because individuals are occasionally infected with more than one organism.

For men younger than 39 years of age, Ceftriaxone, Azithromycin, and Doxycycline are often prescribed. For men older than 39 years od age or those who participate in anal intercourse, Ciprofloxacin, Ofloxacin, Sulfamethoxazole and trimethoprim are often prescribed.

The CDC guidelines recommend that for acute epididymitis most likely caused by enteric organisms or with negative gonococcal culture or PCR nucleic acid amplification test the following:
Ofloxacin (Floxin) 300 mg orally twice a day for 10 days or levofloxacin 500 mg orally once daily for 10 days.

Guidelines change frequently; most health care practitioners who treat epididymitis are aware of these guidelines, and depending on local resistance patterns of pathogens, may change the type and duration of antibiotics to best fit the patient's condition. Pediatric treatments are best administered by pediatricians and are usually based on the weight of the patient and the infecting organism's antibiotic susceptibility. If the infection is not treated early, complications may develop that require surgery.

For patients with non-infectious causes of epididymitis (for example, chemical, inflammation) anti-inflammatory medication is often prescribed; occasionally, consultation with a urologist is recommended for additional treatments.

What is Prostate Calcification - Causes, Symptoms, Diagnosis, and Treatment

What is prostate calcification?

Prostate calcification is a "scar" that remains after prostatitis gets cured. Early stage prostate calcification is a fibrosis of prostate. Common it is occur with no symptom. Such a fibrosis may occur in your body but you feel nothing about it. As prostate fibrosis develops, there would be calcification spots.

What causes prostate calcification?

Prostate calcification can be caused by various of factors: prostate tuberculosis, damage of prostate, parasite ova, and tumour calcification. Slight prostate calcification can also be found on some health men.
Prostate calcification (fibrosis) is the result of the prostate inflammation, which is also a sign of prostate stone. This condition is often found on a small gruop of men who suffered prostatitis and unfurtunatelly there's no specificly way to prevent calcification from developing.

What are prosatate calcification symptoms?

Prostate calcification itself doesn't cause any symptom, this condition is often found after ultrasound or X-ray tests. However as it's often accompanied with chronic prostatitis, men with prosatate calcification may probably experience prostatitis symptoms.

How is prostate calcification diagnosed?

Tests for prostate calcification include:
- Ultrasound
- CT scan
- Prostate biopsy

How is prostate calcification treated?

Prostate calcification spots is a shelter of bacterial and other pathogens, which can hardly be completely eliminated by drugs and microwaves. Those spots can hardly be completely cleared away, also it is unnecessary to completely get rid of them. As long as the spots are not mass in its area or amount, they would bring no negative influences. As a result, some doctors don't make comments on the calcification when they are testing for your prostatitis.
Prostate calcification is often treated with the following methods:

Antibiotics
Antibiotics are the most popular treatment for prostate calcification at present. It is immense to cure acute prostatitis with antibiotics. However, their effect in curing chronic prostatitis is always not that prominent as it is expected. The drug resistance of bacteria and other microbe is a insurmountable hinder of antibiotics. So on some chronic prostatitis sufferers, they may feel an improvement while taking the pills, but symptoms reappear when they stop the treatment. Large doses of antibiotics can be suggested by some doctors, which is with minor possibility of curing prostatitis, but is associated with high risk of hepatotoxicity and nephrotoxicity.

Injection
Injection in gland often exist as a supplement treatment of antibiotic treatment. Because oral intake of antibiotics cannot reach enough concentration in the gland, the injection arises. However, clinical cases in these years found, infections of drugs is also with the defect that it cannot completely cure prostate calcifications.

Physical therapy
Some physical therapies can promote prostate blood circulation by physical measures such as ultrasound. They can promote the release of inflammation. Pathogens cannot be killed by these methods, so they also exist as adjuvant therapies.

Herbal medicine
TCM (traditional Chinese medicine) keep a conception that the fibrosis, calcification and inflammation or prostate are of the same causes: obstruction of heat and dampness in lower abdomen, obstruction of blood and Qi. For the treatment, herbs which can promote blood and Qi circulation, and herbs which can clear away heat and dampness are necessary in the prescription. For long-term inflammation, diuretic herbs are also needed. In as short as 60 days, the calcification spots can be dissolved and dispelled. It can be a safe, radical, and complete cure of prostate calcification.

What is Fallopian Tube Conditions - Causes, Symptoms, Diagnosis, and Treatment

What are fallopian tube conditions?

Common fallopian tube conditions including tubal blockage, tubal adhesions and hydrosalpinx. Pelvic Inflammatory Disease is the major contributing factor in the formation of fallopian tube conditions. Tuberculosis can trigger fallopian tube conditions as well.

Hydrosalpinx is a condition where a woman's fallopian tube has become swollen and filled with fluid. It's a condition that can occur individually without any obstruction of the fallopian tube. Tubal blockage, tubal adhesions and hydrosalpinx are the top causes of infertility in women.


What are fallopian tube conditions causes?

Most commonly a tubal condition can occur due to infection such as pelvic inflammatory disease (PID). The rate of tubal infertility has been reported to be 12% after one, 23% after two, and 53% after three episodes of PID. The Fallopian tubes may also be occluded or disabled by endometritis, infections after childbirth and intraabdominal infections including appendicitis and peritonitis. The formation of adhesions may not necessarily block a fallopian tube, but render it dysfunctional by distorting or separating it from the ovary. It has been reported that women with distal tubal occlusion have a higher rate of HIV infection.

Fallopian tubes may be blocked as a method of contraception. In these situations tubes tend to be healthy and typically patients requesting the procedure had children. Tubal ligation is considered a permanent procedure.


What are fallopian tube conditions symptoms?

Fallopian tube conditions can cause constant or recurring pain in the abdomen. A vaginal discharge may occur. For some women, fallopian tube conditions are asymptomatic, meaning they do not have any symptoms. As fallopian tube conditions cause infertility, it is sometimes discovered only when a woman seeks treatment for infertility issues.


How are fallopian tube conditions diagnosed?

For diagnosing fallopian tube conditions, your doctors would perform X-rays, ultrasound, HSG (hysterosalpingogram), or laparoscopy.

The X-ray procedure involves having a special liquid injected into the uterus. An x-ray is then taken that can detect the liquid's position and progress through the fallopian tubes. A laparoscopy to detect hydrosalpinx is much more accurate, but it is also invasive. The procedure involves passing a laparoscope through a surgical incision in the abdomen. The surgeon can then visually inspect the fallopian tubes. A hysterosalpingogram will demonstrate that tubes are open when the radioopaque dye spills into the abdominal cavity.


What are fallopian tube conditions treatment?

In most cases fallopian tube conditions are cured with surgeries. However, surgery is invasive and has several possible side-effects, one of the most common one being the risk of developing ectopic pregnancies. Very slight condition can receover without any medical care. In other cases, the patients' problems can be solved by medications such as TCM.There are 3 primary techniques of tubal reconstructive surgery:

Tubal Anastomosis - Tubal anastomosis involves removing the blocked segment of the tube and joining the two remaining open segments. It is also referred to as tubal reanastomosis or tubotubal anastomosis. This is the surgical treatment used when the tubal blockage is between the uterus and the fimbrial end of the tube.

Salpingostomy - Salpingostomy is creating a new opening in the fallopian tube. This operation, also called neosalpingostomy, is used to correct distal tubal occlusion at or near the fimbrial end of the tube caused by fimbriectomy, PID, or endometriosis.

Tubal Implantation - Tubal implantation is used to correct a proximal tubal occlusion or blockage at the junction of the fallopian tube and uterus. The blocked segment is bypassed by creating a new opening in the uterus and inserting the healthy portion of the fallopian tube into the uterine cavity. Tubal implantation is also called tubouterine implantation or uterotubal implantation.
 

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