EPIDIDYMITIS: DIAGNOSIS AND THERAPIES

Introduction

After carefully examining the general characteristics of epididymitis, the classification, the main etiological agents and the symptomatological profile that derives from them, in this resolutive article the possible therapies necessary to definitively redeem the patient from epididymitis will be examined in depth, after having thoroughly analyzed the diagnostic picture of the disorder under consideration.

Epididymitis Diagnosis

As soon as the first symptoms of epididymitis appear (pain or tension in the testicle, painful sensation in the groin), it is advisable to contact the doctor, who, to draw up the diagnosis, first proceeds with the "physical examination and palpation of the testicle. , to then perform a "possible more in-depth investigation through rectal exploration, useful for checking the conditions of the vesicles and ascertaining - or denying - a hypothetical enlargement of the prostate. In general, to draw up the diagnosis, the urologist also prescribes tests of the blood and urine, useful to confirm or not the presence of a "bacterial infiltration.
If the clinical picture is not yet clear, despite the aforementioned diagnostic tests, the doctor may also recommend a CT scan of the testicles, an "ultrasound" and screening for venereal diseases.
The CT scan is important to remove the "twisted testicle hypothesis" (topic already discussed in the previous article): this test, to which the affected patient is subjected, is carried out through an "intravenous injection of a radioactive drug substance, useful for highlighting - through specific equipment - both the testicular areas that are most supplied with blood, and those that receive the least. Generally, the abundant blood flow in some areas of the testicle is synonymous with epididymitis; conversely, when poorly perfused, the chances of a testicular torsion increase.
Ultrasound, a clearly non-invasive examination, is useful for highlighting the internal anatomical structures: the patient hypothetically affected by epididymitis is subjected to this simple diagnostic test to exclude testicular neoplasms and, sometimes, also testicular torsion.
Finally, the screening for venereal diseases is carried out by taking a sample of fluid in the urethra (by inserting a thin swab into the penis): the examination is based on the search for pathogenic bacteria. This test, at first glance, does not kindly accepted by the patient, it proves to be very useful for identifying the etiological agent, therefore choosing the most suitable pharmacological treatment to eradicate the beating.

Therapy

For further information: Epididymitis Symptoms

Therapy aimed at treating acute forms of epididymitis mainly includes:

The administration of targeted antibiotics a that particular pathogen (e.g. ofloxacin, doxycycline etc.)

The implementation of therapeutic aids, such as the administration of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs, useful in case of non-bacterial epididymitis), scrotal elevation and the application of ice directly to the scrotum (for severe inflammatory forms). In some cases of severe severity, the patient is hospitalized to monitor the progression of the infection and the response to treatment.

When the pain is excruciating, even the administration of opioids is necessary.

If the therapies listed above are not effective, the operation represents a necessary alternative: the intervention is known as vein ligation (vasectomy), in which an injection of a drug mix (analgesics, steroids, NSAIDs) is performed at the level of the epididymal nerve. Following this delicate medical maneuver, the area affected by the pain heals: the healing, unfortunately, is only temporary, since most of the time, the "pseudo-anesthetic" effect lasts for two or three months. After this period, the pain tends to recur with the same intensity as the previous time: to remedy it, the patient will have to undergo the operation again, so that the symptoms of epididymitis slowly regress.

If the pain continues to recur frequently, despite repeated interventions, partial or total excision of the epididymis (epididymectomy) is recommended, which represents the choice of excellence in the case of scrotal abscess.

If epididymitis is caused by a sexually transmitted disease, the partner should also undergo antibiotic treatment.

Reduce the pain

It is the doctor's duty to explain to the patient all the possible dangers that he could incur not undergoing specific therapy; however, it is helpful to apply some simple prophylactic rules to relieve pain. The patient suffering from epididymitis should remain in bed, in a lying position: by doing so, the tension of the tissues is less and the subject relaxes. Even the applications in loco of ice on the scrotum are effective, as they generate a mild analgesic and anti-inflammatory effect; Obviously, total abstention from sexual intercourse is recommended until the beating responsible for epididymitis is eradicated and the infection completely cured.

In any case, in most cases, epididymitis is an easily treatable disease, even with antibiotics alone, when diagnosed in time; however, the doctor's opinion is always essential.