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PubMed1991

Study of the seminal vesicles in acute epididymitis.

Although it has been suggested that seminal vesiculitis is present in patients with epididymitis, it has not been proven. We performed rectal ultrasound assessment of the seminal vesicles in 18 consecutive patients with epididymitis. The seminal vesicles on the same side as the epididymitis was significantly enlarged in 75% of cases; 92% of these enlarged vesicles returned to normal size in 12 weeks. A persistently enlarged seminal vesicle was associated with unresolved epididymitis, and further bacteriological studies in these cases demonstrated continued Chlamydia infection in some patients over 35 years of age.

Acute Disease↗

PubMed1986

Microbiological survey of acute epididymitis.

In an 18 month period, 198 men presented with a painful, swollen, and tender epididymis or testicular or scrotal pain. Fifty were excluded from analysis because of prior antibiotic treatment or a history of the disease, or both. Of the remaining patients, epididymitis was not diagnosed in 108, though 23 (21%) of them had urethritis. Thus 40 men were seen who had acute unilateral epididymitis. Of the 27 less than 35 years old, 13 (48%) had a urethral chlamydial infection and two others a gonococcal infection. Sexually transmitted micro-organisms were not confined, however, to the younger age group, though only two (15%) of 13 men who were 35 years or older had a urethral chlamydial infection. Most, that is 29 (73%), of the patients with acute epididymitis also had urethritis when first seen. Urethral micro-organisms were found most often in 13 men who had severe epididymitis, chlamydial infection occurring in eight (62%) of the patients in this category.

Acute Disease↗

PubMed2000

Epididymitis in children: is further investigation necessary after the first episode?

OBJECTIVE: The aim of this study was to evaluate the usefulness of investigating underlying urinary tract pathology after the first episode of acute epididymitis in children with no prior urological history, and also to assess the possible predictive factors of urological disease at the time of diagnosis. METHODS: Children with acute epididymitis were studied retrospectively over a period of 8 years. Diagnosis was made either using ultrasonography or surgical exploration. Renal ultrasonography and voiding cystourethrography were performed 1 month after epididymitis. RESULTS: These tests were carried out in 38 children who revealed 7 anomalies (18%). Only 1 patient received further surgery : endoscopic treatment of a ureterocele. We also studied 3 predictive factors: age <2 years; recurrence, and urine bacteria. None could be associated with the presence of urinary tract pathology. CONCLUSION: The authors suggest that, when there is no previous urological anomaly and absence of bacteriuria, routine screening for epididymitis should be carried out following the second episode.

Acute Disease↗

PubMed1983

Chlamydia trachomatis in acute epididymitis.

The etiology of acute epididymitis was studied in 52 patients. Infection with Chlamydia trachomatis was demonstrated by culture or serology in 13 patients. In men under the age of 25 C. trachomatis was associated with 7 out of 9 cases of epididymitis, in contrast to none of the 19 cases in men above 35. Culture from the urethra is probably sufficient in diagnosing infection with C. trachomatis in patients with acute epididymitis, since only one patient with a negative urethral culture had a chlamydia-positive aspirate from the epididymis. Half of the cases of epididymitis in men above the age of 35 years were associated with urinary tract infection. One patient was infected with N. gonorrhoeae and one had tuberculosis of the epididymis.

Acute Disease↗

PubMedDate not supplied

Cloning and characterization of an androgen-dependent acidic epididymal glycoprotein/CRISP1-like protein from the monkey.

A cDNA encoding an acidic epididymal glycoprotein (AEG)-like, CRISP1 (cysteine-rich secretory protein) protein from the monkey (Macaca mullata) epididymis has been cloned and sequenced. The monkey AEG (mAEG) has an open reading frame that encodes a protein containing 249 amino acids with a deduced molecular mass of 28 kDa. The mAEG protein sequence is 85% identical to human and 44% identical to mouse CRISP1, including all 16 conserved cysteine residues. mAEG also shows a significant amino acid homology with other CRISP proteins, rat AEG/DE, human TPX1/CRISP2, and guinea pig acrosomal autoantigen 1 (AA1). In addition, mAEG shows somewhat less homology to a toxin from the Mexican beaded lizard and to a human glioma pathogenesis-related protein. Northern blot analysis shows that the mRNA for mAEG is expressed in all the regions of the epididymis except the caput and was not detected in the testis, prostate, seminal vesicle, and brain. In castrated animals, mAEG gene expression in the epididymis is significantly diminished; however, testosterone enanthate replacement restored the normal level of expression, demonstrating that expression of mAEG is androgen dependent. Western blot analysis of monkey epididymal regions using mouse antirecombinant human AEG identified a 28-kDa protein only in the caudal region. Immunohistochemical analysis identified mAEG only in the principal cells of the cauda epididymal epithelium. Immunofluorescence analysis identified mAEG on the principal piece of the sperm tail and as small patches over the middle piece and head regions. The results described in the present study suggest that mAEG (CRISP1) is secreted in the monkey epididymis, regulated by androgens and present on epididymal spermatozoa.

Amino Acid Sequence↗

PubMed1975

[Epididymitis Tuberculosa in the Change of Time. A study of the bioptic material of forty years (1932-1971)].

Significance and course of epididymitis tuberculosa are explored by means of all the bioptic material of a forty years period. The results from the time before and after the introduction of the tuberculostatica are compared with each other. Shortly before and during the second world war and also at the end of the fifties the epididymitis tuberculosa was seen very frequently. It decreases since 1959. Generally the isolated epididymis is affected. In a number of cases the tuberculous inflammation is also spreading out to the homolateral testicle, the vas deferens and the tunica vaginalis testis. Evidently during the third decade the tuberculous epididymitis is increasing rapidly. Most cases are observed in the forth decade. The morphologic picture of the epididymitis tuberculosa has changed. During the first 20 years more cases of the granulomatous type have been observed, whereas during the following 20 years more cases of the necrotising type are present.

Adolescent↗

PubMed2003

[Tuberculous epididymitis caused by intravesical BCG therapy: a case report].

We describe a case of tuberculous epididymitis that occurred 35 months after completion of a course of intravesical Bacillus Calmette-Guerin (BCG). A 67-year-old man had received trasuretheral resection for bladder cancer in February 1997. Two weeks after the operation, a course of 8 weekly intravesical instillations of BCG (Tokyo 172 strain) was carried out between March and April, 1997. Under the diagnosis of benign prostatic hypertrophy, transuretheral resection of the prostate was performed in March 1998. Multiple tuberculous nodules were histopathologically detected in resected prostatic tissues. The patient complained of a small nodule in the right epididymal tail in August 2001. The nodule developed during 6 weeks, with spontaneous perforation of the scrotal skin and discharge of pus. The pus contained acid-fast bacilli, which were shown to be tubercle bacilli by polymerase chain reaction (PCR) with pan-mycobacterium primer. MPB64-T2, T6 and pncA-7, 11C were positive, while PT-1, 2 and pncA-7, 10 were negative by PCR. These results revealed that Mycobacterium bovis (BCG Organism) was the cause of the epididymitis. Drug therapy for 3 months with rifampicin, isoniazid and ethambutol was initiated in September 2001, and right orchiectomy was performed in October. Histopathological examination showed tuberculous epididymitis. In this case, persistent BCG organisms may have reached the epididymis from the prostate, and may have been activated by immunosuppression associated with aging. In addition, PCR with species-specific primers was useful in differentiating Mycobacterium bovis from Mycobacterium tuberculosis.

Administration, Intravesical↗

PubMed1991

[Diffusion of norfloxacin in epididymal tissue].

Norfloxacin, a "second generation" compound of the quinolone group, was administered orally, before surgery, every 12 h during successive three-day periods at dose of 400 mg to ten patients hospitalized for prostatic adenoma or for prostatic cancer. On the day of surgery, a 400 mg-last dose was administered. Unchanged norfloxacin was assayed by high performance liquid chromatography with fluorescence detection. The Cmin value was 1.2 +/- 0.77 mg/l. Concurrent norfloxacin concentrations in plasma and epididymal tissue (left and right) were determined, about 4 h after the last drug intake, the epididymal level was 3.4 +/- 1.9 micrograms/g. This value was above the MIC90 for most sensitive organisms. The ratio (+/- SD) of drug concentration in epididymal tissue and in plasma was 3. 74 +/- 2.10 (range 1.66-10.2). The epididymal level of norfloxacin was strongly correlated with, area under curve (p less than 0.001) and plasma concentration (p less than 0.01).

Aged↗

PubMed1987

[Epididymitis. Apropos of 82 cases].

The authors report 82 cases of epididymitis, studied from 1976 to 1985: 66 acute epididymitis and 16 chronicle epididymitis. It is the affection of young patients: middle age 39 years. The frequency of epididymitis seems to increase the last years. The coliform organisms were the predominant pathogens isolated from the patients more than 35 years old; for patients less than 35 years old, in most cases, the Chlamydia trachomatis was the cause of infection. Among 12 patients with Chlamydia trachomatis infection, 11 were less than 35 years old. The treatment before the results of the sample has to be the Doxycycline; if Chlamydia trachomatis is not the cause of infection, the treatment will be changed. The corticotherapy is always associated with antibiotics, and his action is discussed.

Acute Disease↗

PubMed1979

Testicular torsion and epididymitis demonstrated by radionuclide angiograms and static imaging.

Radionuclide testicular angiography and static images were performed using technetium 99m sodium pertechnetate in an effort to differentiate between testicular torsion and acute epididymitis in 12 patients. The diagnosis of testicular torsion was made in four cases that were confirmed at surgery. Acute epididymitis or acute epididymo-orchitis was diagnosed six times. These patients were treated with broad-spectrum antibiotics leading to a subsidence of their clinical symptomatology during therapy with no sequelae. The radionuclide angiogram and static image changes of chronic epididymitis are also discussed.Radionuclide testicular angiograms and static images can be significant benefits in addition to the clinical and physical findings to distinguish between testicular torsion and acute and chronic epididymitis.

Diagnosis, Differential↗

PubMed1984

Acute epididymitis and Chlamydia trachomatis.

Prostatitis and epididymitis, which are the most common complications of urethritis in men below 35 years of age may be associated with Chlamydia trachomatis infection. Chlamydiae have been isolated from expressed prostatic fluid in men with urethritis complicated by prostatitis and epididymitis. Epididymitis seem to be an established complication of chlamydial urethritis particularly when urethritis is complicated with prostatitis. Since epididymitis may lead to reduced fertility, prompt antibiotic treatment using tetracyclines should be administered to patients with this condition.

Acute Disease↗

PubMed1995

Local expression of cytokine messenger RNA in rat model of Escherichia coli epididymitis.

PURPOSE: In order to investigate whether cytokines play an important role in the regulation of host defense against bacterial epididymitis, we examined the local expression of cytokine mRNA in a rat model of Escherichia coli epididymitis. MATERIALS AND METHODS: Escherichia coli was inoculated into the spermatic cord of the rats and provoked epididymitis. At 6, 12, 24, 48, and 72 hours postinfection (p.i.) epididymides were harvested. We examined interleukin-6 (IL-6) and other inflammatory cytokine mRNAs in epididymides by Northern blotting and reverse transcriptase polymerase chain reaction (RT-PCR). Histopathological findings and immunohistochemistry for IL-6 were also examined. RESULTS: Infected epididymides expressed IL-6 mRNA maximally at 6 hours p.i. and then the signal decreased by Northern blotting. mRNA for IL-1 beta and TNF-alpha also increased within 6 hours by RT-PCR. Histopathological examination showed that no inflammatory cells were observed at 6 hours p.i. and that inflammatory changes were most prominent at 72 hours p.i. Epididymal epithelium expressed IL-6 locally in response to local bacterial infection by immunohistochemistry. CONCLUSIONS: mRNA for IL-1 beta, IL-6, and TNF-alpha is expressed locally in response to bacterial infection before inflammatory cell infiltration. This rapid expression in the epithelial cells may be important in host defense to local genital infection.

Animals↗

PubMed1993

[Chlamydia trachomatis infection in young men with acute epididymitis and their sexual partners].

Untreated infection of female partners by men with chlamydial epididymitis may have serious effects on the partners' fertility. To assess the need for detailed microbiological investigation, 32 patients, 35 years old or younger, with epididymitis and their sexual partners were examined. The patients underwent thorough evaluations, including chlamydia isolation, microscopy of urethral swab, bacterial culture, and chlamydia serologic testing. An infective cause was identified in 56% of the patients. The most common microorganism was Chlamydia trachomatis. This microorganism was identified from urethral swabs in 11 patients (34%). A total of 18 sexual partners were traced and investigated for chlamydia antigen by cervical swab, urinary bacterial culture, and chlamydia serologic testing. Of the 18 female sexual partners screened, 9 were partners of patients with chlamydial epididymitis; 78% of these women had the same infection. Young men with epididymitis, as well as their partners, should undergo full microbiological evaluation including Chlamydia trachomatis for adequate treatment of this infection.

Acute Disease↗

PubMed1996

Acute epididymitis: a work-related injury?

Occupational medicine physicians frequently are presented with requests by employers to determine the work-relatedness of medical illnesses or injuries. Occasionally, this involves a sudden onset of acute epididymitis in the male employee after strenuous activity in the workplace. Because the vast majority of acute epididymitis cases have an underlying sexually transmitted disease component, this poses a real dilemma for the consulting physician. This article discusses the etiology and pathogenesis of acute epididymitis along with its epidemiologic significance and reviews workers' compensation and its possible legal interpretation when acute epididymitis occurs at the worksite.

Acute Disease↗

PubMed1996

[Epididymal manifestations of urogenital tuberculosis].

The morbidity of tuberculous epididymitis is due to the risk of male infertility secondary to vasal or epididymal obstruction or testicular necrosis. The aim of this study was to emphasize the epidemiological, clinical and therapeutical aspects of tuberculous epididymitis in adult. About eleven cases of epididymal localisation of urogenital tuberculosis, it appears that the diagnosis of the condition is rather difficult and often necessitate pathological exam of a specimen of epididymectomy. In other aspects, if antituberculous drugs are always effective in initial stages, surgery is usually radical, and rarely conservative. The latter procedures are vasovasostomy or vasoepididymostomy whose results are very hazardous.

Adult↗

PubMed2001

Novel sperm-binding proteins of epididymal origin contain four fibronectin type II-modules.

Novel fibronectin type II (Fn2)-module proteins were cloned from human and canine epididymal cDNA libraries. cDNA sequences predicted a highly conserved protein family, related but not homologous to ungulate seminal plasma proteins (approximately 50% sequence identity), and the first known examples of proteins with four tandemly arranged Fn2-domains. By Northern blot and in situ hybridization analyses the encoding mRNAs were shown to be abundant products of the epididymal duct epithelium, but not detectable in other tissues. Homologous mRNAs were identified in the epididymides of various mammals, representing members of this novel protein family of epididymal origin. Within the Fn2-module-encoding stretches, species homologues displayed >85% sequence identity, but showed high variability at their predicted N-termini. An antipeptide antiserum in Western blot analyses detected 30-35 kDa immunoreactive protein bands in epididymal tissue, cauda epididymidal fluid, and sperm membrane protein preparations. The tandem arrangement of increasing numbers of Fn2-modules might functionally correspond to the tendency to form oligomers that has been described for lipid-binding proteins.

Amino Acid Sequence↗

PubMed1985

Immunodissection of sperm surface modifications during epididymal maturation.

Mammalian spermatozoa undergo changes in morphology, composition, and function during transit through the epididymis. These changes correlate with acquisition by sperm of the ability to fertilize ova. It has been found that sperm from the cauda epididymidis, but not those from the caput epididymidis, are able to bind to the zona pellucida. This would imply a modification in sperm surface characteristics. Biochemical and immunological studies have demonstrated changes in sperm surface composition during epididymal maturation. These changes involve addition of epididymal secretory products to the sperm surface, loss or alteration of existing sperm surface molecules, and possibly the unmasking of preexisting molecules or epitopes. Several laboratories have studied the epididymal secretory proteins in the rat, but a consensus has not been reached on the identification, characterization, source, and sperm surface association of these proteins. Monoclonal antibodies are beginning to be used to characterize sperm surface components and sperm maturation antigens. They are proving to be valuable tools for the dissection of epididymal maturation when used in conjunction with biochemical and physiological approaches.

Animals↗

PubMed1992

Changes in the distribution of filipin-sterol complexes in the boar sperm head plasma membrane during epididymal maturation and in the uterus.

The distribution of filipin-sterol complexes (FSCs) and intramembranous particles (IMPs) in the plasma membrane of the late spermatid of the boar and of the sperm obtained from the epididymides, ejaculates, and uterus 2 hours after mating was examined by a freeze-fracture replica technique. In the late spermatid, the FSC density was found to be very low. A majority of the FSCs in the acrosomal plasma membrane (APM) appeared as protuberances on the E face in the epididymal, ejaculate, and uterine sperm. The density of the FSCs in the principal segment (PS) of the APM was 291 +/- 44 FSC/microns2 (mean +/- standard deviation, S.D.), 322 +/- 41 FSC/microns2 and 355 +/- 31 FSC/microns2 in the caput, corpus, and cauda epididymidis, respectively. In comparison with the cauda epididymal sperm, the FSC density gradually decreased in the PS of the ejaculated (277 +/- 39 FSC/microns2) and uterine sperm (243 +/- 50 FSC/microns2). The reduction was especially remarkable in the equatorial segment (ES), where the density of FSCs in ejaculated and uterine sperm decreased to about half and less than half of that in the cauda epididymal sperm, respectively. Large (13 nm) and small (8 nm) IMPs were distributed evenly and densely in the P face of the APM in the late spermatid, epididymal, and ejaculated sperm. In the uterine sperm, IMP-free areas were observed in the P face of the plasma membrane, a feature thought to represent one of the capacitation changes of the boar sperm.

Animals↗