PubMed1986
A series of 86 cases of acute epididymitis observed over a period of 3 years is analyzed and findings reported. Testicular lesions were frequent and 35% of these cases involved a purulent testicular pocket. The epididymal lesion was usually of a total nature (77% of cases), only the tail of the epididymis being involved in 17%. Sterile urine was a frequent finding (50% of cases). Chlamydiae were rarely identified, but administration of medication ineffective against chlamydiae was effective in most cases, suggesting that these organisms are a rare cause of acute epididymitis. Iatrogenic epididymitis was a frequent diagnosis when compared with epididymitis due to cases of known cervico-urethral obstruction. Catheterization, endoscopic resection of prostate, transvesical prostatic adenomectomy were the main cause in the absence of ligature of deferens, the latter being considered as a certain preventive procedure. The affection is possible in children or adolescents (3 cases between 10 and 16 years) with an acute hydrocele as the presenting sign. Tuberculosis is still a possible cause (5 cases) with Koch's bacillus present in the urine in 4 of these patients. In the majority of cases, however, the etiology was unknown (62 of 86 patients = 72%). Treatment can be by a cycline as sole therapy, anti-inflammatory steroid or non-steroid agents also being effective. Medical treatment was rapidly and totally effective in 56 of the 86 patients, but residual foci were noted in 19 of 86 cases. Epididymectomy may be necessary for painful lesions or recurrence of epididymitis, while castration may be indicated (6 cases) for fistula formation, purulent pockets of testis, or ischemic necrosis of testis.(ABSTRACT TRUNCATED AT 250 WORDS)