Epididymitis

　　Epididymitis often occurs secondary to post-urethral inflammation, prostatitis, and seminal vesiculitis. The following situations are prone to cause epididymitis:

　　Some patients report a history of scrotal injury before epididymitis, but not all patients with scrotal trauma develop epididymitis.

　　After the prostatectomy, especially transurethral prostatectomy, since the seminal duct orifice is located in the prostatic fossa, the pressure of urination can reflux urine into the seminal duct. Within 8 to 12 weeks after the prostatectomy, urine often contains a certain number of bacteria.

　　Long-term indwelling catheterization of the urethra and urethral instrumental examination can induce prostatic infection, followed by epididymitis.

　　附睾炎是如何引起的，附睾炎的常见致病菌以大肠杆菌多见，其次是变形杆菌、葡萄球菌、肠球菌及绿脓杆菌等，沙眼衣原体也可引起急性附睾炎。致病菌多经输精管逆行进入附睾。此外，细菌侵入附睾也可经淋巴管或经血行感染引起附睾炎，但少见。

　　附睾炎在青壮年男性中是一种多发病，当身体抵抗力下降时，病原菌就可能侵袭附睾，从而引起炎症。附睾炎严重威胁着男性的健康，如果不及时治疗，可能会引起并发症，给身体造成压力。

　　1、精囊炎，精囊炎的主要临床表现为血精，伴有尿频、尿急、排尿不适及会阴部不适等症状，常与前列腺炎并存。中医认为精囊炎的病因病机是病邪由外入里，脏腑失调，气血不和，引起精囊脉络受损，血溢脉外。

　　2、慢性前列腺炎，慢性前列腺炎以尿急、尿频、尿道灼痛不适，尿末流出白色浊液，会阴、少腹、睾丸及尿道内不适或涩痛为主要临床表现。

　　3、附睾炎久治不愈可造成精损肾亏、元气耗损、肢体寒冷、腰酸背疼、提早衰老。

　　4、附睾炎可导致男性性功能下降，甚至完全丧失性功能。

　　5、附睾炎可导致死精、无精、丧失生育能力，并且可将炎性病菌传染给配偶，造成妇科疾病。

　　6、附睾炎可能诱发严重的疾病，如精索静脉曲张、精索炎、内分泌疾病、肾炎等肾脏疾病、泌尿系统感染、恶性肿瘤等。

　　附睾炎是一种蜂窝组织炎，始于射精管并蔓延至附睾的尾部。急性期，附睾肿胀，质地较硬，感染由附睾的尾部向头部扩散，长表现为在腹股沟区有压痛，阴囊增大，局部皮肤红肿，如脓肿形成，皮肤呈现干性变薄，易脱落。具体症状如下：

　　一、急性附睾炎的症状

　　急性附睾炎发病较急，伴有高热现象且白细胞突然升高，患侧阴囊胀痛而有沉坠感，下腹部及腹股沟部有牵扯痛，站立或行走时疼痛加剧。患侧附睾肿大，有明显压痛。炎症范围较大时，附睾和睾丸均有肿胀，两者界限触摸不清，称为睾丸附睾炎。患侧的精索，亦有压痛。一般情况下，急性症状可于一周后逐渐消退。

　　二、慢性附睾炎的症状

　　慢性附睾炎的症状比急性附睾炎多见，部分病人系急性期未能治愈而转为慢性。该病较多见，部分病人因急性期未能彻底治愈而转为慢性，但多数病人并无明确的急性期，炎症多继发于慢性前列腺炎或损伤。病人常感患侧阴囊隐痛，胀坠感，疼痛常牵扯到下腹部及同侧腹股沟，有时可合并有继发性的鞘膜积液。检查时附睾常有不同程度的增大变硬。有轻度压痛。

　　Epididymitis is a common male urological disease. Many people are not familiar with the epididymis, which is the necessary path for sperm and also an organ for spermatogenesis. Therefore, once the epididymis has a problem, it may cause male infertility. Epididymitis can cause scrotal pain,坠胀感, and the following are the best ways to prevent epididymitis:

　　1. Do not have an early romance or early sexual activity:If a male reproductive organ is not fully developed and sexual activity is initiated prematurely, it can consume the sperm, easily causing varying degrees of orchitis and sexual dysfunction, and it is more likely to occur in adulthood, such as premature ejaculation, impotence, lumbago, and premature aging.

　　2. Do not wear jeans frequently:Generally, the male reproductive system requires a lower temperature, and the testicles can mature and develop better in an environment a few degrees lower than the human body temperature. Therefore, wearing jeans frequently can raise the local temperature, which is not conducive to sperm formation, especially in summer and when the climate is humid.

　　3. Avoid frequent and dense sexual activity:If one indulges in sexual desire without节制, the reproductive organs will be chronically engorged, leading to a decrease in sexual function and an increased risk of orchitis, prostatic diseases, and sexual dysfunction.

　　4. To prevent orchitis, one must avoid unclean sexual life:Many patients with orchitis are often related to unclean sexual contact, so one must maintain clean living.

　　5. Pay attention to self-examination in daily life:Any disease is best detected and treated early for higher cure rates. This is especially true for male testicle and penis lesions, as treatment becomes less ideal when they develop into advanced stages.

　　6. Pay attention to urogenital hygiene and prevent bacterial infection:Not only women should pay attention to personal hygiene, but male comrades should also attach great importance to it, especially those with phimosis and过长 foreskin. They should frequently turn and clean the penis to remove smegma, because smegma is not only easy to repeatedly stimulate the glans, causing balanoposthitis, orchitis, and other diseases.

　　Epididymitis is more common in middle-aged and young adults, and can be divided into acute epididymitis and chronic epididymitis according to the course of the disease. Acute epididymitis often occurs due to the spread of inflammation from adjacent organs along the vas deferens to the epididymis. Procedures such as urethral instrument operations, frequent catheterization, and indwelling catheters after prostatectomy are all easy to cause epididymitis. Incomplete treatment of acute epididymitis can lead to chronic epididymitis. So, what kind of examination is needed for epididymitis? Generally, the examination of epididymitis includes the following methods:

　　1. Laboratory Examination:The peripheral blood leukocyte count can reach (2-3) * 10^9/L, and urethral discharge can be subject to stained or unstained examination. Urinalysis is also an important examination method for epididymitis.

　　2. Ultrasound Examination:It can show the swelling and inflammatory range of the epididymis and testicle.

　　3. Magnetic Resonance Imaging (MRI) Examination:Epididymitis is diffuse or focal, and the T2-weighted image of the epididymis signal can be the same as or higher than that of the testis.

　　Epididymitis, as a male reproductive infection disease, has a serious impact on the male reproductive system. If not treated in time, it may lead to symptoms such as male infertility. At the same time, male patients should also pay attention to some dietary taboos when treating epididymitis. Diet plays a significant role in the treatment of epididymitis.

　　1. Eat more fibrous vegetables and fruits such as bananas, sweet potatoes, celery, etc., to keep the bowels smooth.

　　2. Red bean or mung bean soup has the effect of clearing heat, promoting diuresis, and detoxifying, and drinking it regularly can help the recovery of this disease.

　　3. Eat more fresh vegetables and fruits to increase the intake of vitamin C and other components to enhance the body's anti-inflammatory ability.

　　Epididymitis is a common disease in young and middle-aged adults, which is clinically divided into acute epididymitis and chronic epididymitis. The specific treatment is as follows:

　　1. Treatment of Acute Epididymitis

　　(1) General treatment includes bed rest, using a scrotal support or a homemade soft pad to support the scrotum can alleviate symptoms. Painful patients can use analgesics, local heat therapy can relieve symptoms and promote the regression of inflammation. However, early use of heat therapy can worsen pain and has the risk of promoting the spread of infection. Therefore, local cold compresses with ice packs should be used early. Sexual activity and physical labor can worsen infection, so they should be avoided.

　　(2) Antibacterial drugs should be selected for bacteria-sensitive drugs, usually intravenous administration for 1-2 weeks, followed by oral antibacterial drugs for 2-4 weeks to prevent the transformation into chronic inflammation.

　　(3) If antibiotic treatment is ineffective and there is a suspicion of testicular ischemia, epididymal incision and decompression should be performed, multiple longitudinal or transverse incisions should be made in the epididymal serosal layer, but care should be taken not to injure the epididymal duct.

　　2. Treatment of Chronic Epididymitis

　　The effect of medication alone for chronic epididymitis may not be ideal. In addition to the use of effective broad-spectrum antibiotics, local hot compresses and other physical therapies are also very necessary. Local application of berberine or neomycin and other ions by iontophoresis can also be adopted. If there is chronic prostatitis, it must be treated simultaneously. Recurrent epididymitis originating from chronic prostatitis can consider vasectomy before treatment. For those who have recurrent attacks, epididymectomy can also be considered.