Post Date December, 02 2023
Epididymitis is one of the common male infertility diseases. If it occurs, it is necessary to seek medical attention in a timely manner to avoid delaying the optimal period of treatment.
"Male patients with epididymitis are prone to abnormal infertility in the seminal tract. So, what test methods are commonly used in clinical diagnosis of epididymitis?"? There are three commonly used methods for clinical examination and diagnosis of epididymitis: laboratory examination, ultrasound examination, and magnetic resonance imaging.
Etiology of epididymitis
The common pathogenic bacteria are Escherichia coli, followed by Proteus, Staphylococcus, Enterococcus, and Pseudomonas aeruginosa. Chlamydia trachomatis can also cause acute epididymitis. Pathogenic bacteria often enter the epididymis retrogradely through the vas deferens. In addition, bacterial invasion of the epididymis can also cause epididymitis through lymphatic or hematogenous infections, but it is rare.
Acute epididymitis is prone to occur in the following clinical situations:
① Prolonged indwelling of urethral catheters and intraurethral instrumentation can induce prostate infection, followed by acute epididymitis;
② After prostatectomy, especially transurethral resection of the prostate, due to the opening of the ejaculatory tube in the prostatic fossa, urethral pressure during urination can reverse flow of urine into the ejaculatory tube. Within 8-12 weeks after prostatectomy, urine often contains a certain amount of bacteria;
③ Some patients have a history of scrotal injury before complaining of acute epididymitis, but not all patients with scrotal trauma develop acute epididymitis.
Pathology of epididymitis:
Epididymitis can occur on one or both sides, most commonly on one side. Acute epididymitis often occurs first from the tail of the epididymis, with edema and desquamation of the epithelium of the epididymis tube, and the presence of purulent secretions within the lumen, which then infiltrates through the stroma to the body and head of the epididymis, and can form small abscesses. The late stage scar tissue forms an obstruction of the epididymis lumen, so bilateral epididymitis often causes infertility.
Examination method 1 for epididymitis: laboratory examination
Peripheral blood leukocytes can reach (2-3) × 109/L。 Urinary secretions can be examined for staining or non staining. Urine analysis is also an important examination method.
Examination method 2 for epididymitis: ultrasonic examination
The swelling and inflammatory range of the epididymis and testis can be displayed.
Examination Method 3 for Epididymitis: Magnetic Resonance Examination
Epididymitis is diffuse or focal, and its T2 weighted signal can be the same as or higher than that of the testis.
(Intern Editor: Huang Jiazhen)
