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PubMed2000

Mammalian sperm-egg fusion: evidence that epididymal protein DE plays a role in mouse gamete fusion.

Rat epididymal protein DE associates with the sperm surface during epididymal maturation and is a candidate molecule for mediating gamete membrane fusion in the rat. Here, we provide evidence supporting a role for DE in mouse sperm-egg fusion. Western blot studies indicated that the antibody against rat protein DE can recognize the mouse homologue in both epididymal tissue and sperm extracts. Indirect immunofluorescence studies using this antibody localized the protein on the dorsal region of the acrosome. Experiments in which zona-free mouse eggs were coincubated with mouse capacitated sperm in the presence of DE showed a significant and concentration-dependent inhibition in the percentage of penetrated eggs, with no effect on either the percentage of oocytes with bound sperm or the number of sperm bound per egg. Immunofluorescence experiments revealed specific DE-binding sites on the fusogenic region of mouse eggs. Because mouse sperm can penetrate zona-free rat eggs, the participation of DE in this interaction was also investigated. The presence of the protein during gamete coincubation produced a significant reduction in the percentage of penetrated eggs, without affecting the binding of sperm to the oolemma. These observations support the involvement of DE in an event subsequent to sperm-egg binding and leading to fusion in both homologous (mouse-mouse) and heterologous (mouse-rat) sperm-egg interaction. The lack of disintegrin domains in DE indicates that the protein interacts with its egg-binding sites through a novel mechanism that does not involve the reported disintegrin-integrin interaction.

Animals↗
PubMedDate not supplied

Etiology of acute epididymitis presenting in a venereal disease clinic.

Sixteen patients aged 19-42 years and suffering from acute epididymitis were investigated. In twelve patients evidence of acute epididymitis developed without premonitory urethral symptoms. The only microbiologic finding for ten patients was Chlamydia trachomatis; both C. trachomatis and Neisseria gonorrhoeae were isolated from four patients. Two patients, who had recently had antibiotic treatment, harbored neither of these microorganisms. These observations indicate that C. trachomatis must be considered a dominant cause of acute epididymitis in the younger age groups. This fact has implications for the choice of treatment (erythromycin or tetracycline) and the investigations and treatment of sexual contacts.

Acute Disease↗
PubMed2006

Chlamydial seminal vesiculitis without symptomatic urethritis and epididymitis.

We previously reported that seminal vesiculitis was associated with acute epididymitis, and that Chlamydia trachomatis was the major causative pathogen for infection of the seminal vesicle, suggesting that seminal vesiculitis was a discrete disease entity. In this paper, we report two patients with bacteriologically and cytologically proven seminal vesiculitis who had asymptomatic urethritis but not epididymitis. The clinical courses of these patients suggest that chlamydial seminal vesiculitis may be a cause of asymptomatic infection of the urethra or subsequent development of acute epididymitis.

Adult↗
PubMed1982

Intravenous urography as a routine examination in epididymitis-a re-evaluation.

One hundred and twenty-seven intravenous urograms of patients with acute epididymitis were evaluated during a period of 9 years. The majority of these patients had normal urograms. A tuberculous renal lesion was found in only one case. Twenty-seven patients had prostatic enlargement and 10 of these were under 50 years of age. Other abnormalities which were found were not related to epididymitis. It is suggested that intravenous urography is indicated in patients with acute epididymitis only when there is evidence of previous tuberculosis or when laboratory findings arouse suspicion of genitourinary tuberculosis.

Adolescent↗
PubMed1987

The role of Chlamydia trachomatis in epididymitis.

Microbiological studies have identified an infective micro-organism in 28 of 54 patients (52%) with epididymitis. Chlamydia trachomatis was the commonest infection isolated, occurring in 15 patients. An additional 17 patients (31%) who were culture negative had serological evidence which suggested recent chlamydial infection. Most patients with chlamydia were under 26 years of age, in contrast to patients over 35 years, in whom coliform infections predominated. Of the 12 consorts of patients with chlamydial epididymitis who were screened, nine were also positive for this micro-organism. These findings have important implications in the management of epididymitis, especially in young men.

Adolescent↗
PubMed1990

Acute epididymitis: why patient and consort must be investigated.

In this prospective study of 49 patients under 35 years of age with clinically diagnosed epididymitis, detailed microbiological investigation identified an infective cause in 67%. Chlamydia trachomatis was the commonest agent, present in 25 patients, but in 12 of these detection was based solely on raised antibody titres; 20 of the 28 female consorts screened were partners of men with chlamydial epididymitis and 80% of them were also positive for this infection. Isolating the micro-organism from 14 of 16 consorts indicated active infection despite the negative swabs from the men. If this important infection is to be adequately treated we recommend that all patients in this age group with epididymitis and their partners should be referred to a specialist unit with access to full chlamydia laboratory facilities.

Acute Disease↗
PubMed2005

Tuberculous epididymitis: a case report and literature review.

Tuberculous epididymitis is a rare urological disease difficult to diagnose. The conventional methods for diagnosis are often time-consuming and invasive. The combined use of scrotal magnetic resonance imaging (MRI) and urinary polymerase chain reaction (PCR)-based assay for mycobacterial DNA (the latter because of its high sensitivity and specificity to demonstrate mycobacterial DNA) is a valuable method for rapid diagnosis of tuberculous epididymitis. We report a 79-year-old man who was admitted with the chief complaints of bilateral scrotal swelling and pain. The combined use of scrotal MRI and urinary PCR allowed prompt diagnosis of tuberculous epididymitis and adequate antituberculous therapy.

Aged↗
PubMed1992

Experimental epididymitis due to Chlamydia trachomatis in rats.

A new animal model of epididymitis due to Chlamydia trachomatis was developed. Adult male Wistar rats were inoculated in the vas deferens with C. trachomatis biovar mouse pneumonitis. After infection, C. trachomatis was recovered from the epididymides for up to 90 days. At day 30, organisms were also reisolated from the testes. Clinical findings included enlargement of infected epididymides and concurrent atrophy of the ipsilateral testes. Histological lesions in the epididymides consisted of pyogranulomatous inflammation, abscesses, and spermatic granulomas. Infection of the testis by C. trachomatis was associated with pyogranulomatous changes. In addition, testicular degeneration, characterized by moderate to severe loss of the germinal epithelium, was noted. Chlamydial antigen was detected within epithelial cells, intratubular macrophages, and macrophages in the stroma of the epididymis by immunoperoxidase staining. This rat model of chlamydial epididymitis appears to clinically and histopathologically mimic the human disease. This model offers the opportunity for further studies on the pathogenesis and sequelae of chlamydial epididymitis.

Animals↗
PubMed1989

Epididymitis caused by treatment with amiodarone.

Epididymitis is described in a man aged 33 who had been treated with the antiarrhythmic agent, amiodarone. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of non-infectious epididymitis has been reported. This additional case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.

Adult↗
PubMed1993

Microbiology of acute epididymitis in a developing community.

OBJECTIVE: To investigate the aetiology of acute epididymitis in a developing community with a view of determining appropriate antimicrobial therapy. SETTING: City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa. PARTICIPANTS: 144 adult men with clinically diagnosed acute epididymitis. METHOD: Endourethral swab and midstream urine (MSU) specimens were processed to detect sexually transmitted pathogens and urinary tract infections. RESULTS: The majority of patients (93%) were less than 35 years of age. Neisseria gonorrhoeae and/or Chlamydia trachomatis were detected in 78% of patients: N gonorrhoeae in 57%, C trachomatis in 34% and both in 13%. Escherichia coli was cultured more frequently from MSU specimens of older patients, 30% versus 3%. In 53% of patients urethritis was diagnosed by the presence of inflammatory cells in endourethral smears in the absence of a visible urethral discharge. CONCLUSION: In our setting of a busy clinic with limited facilities, we recommend the performance of a Gram stain on endourethral specimens from patients with acute epididymitis. If inflammatory cells and Gram negative diplococci are detected, treatment with antimicrobial agents to cover both penicillinase-producing N gonorrhoeae strains and C trachomatis is recommended. If Gram negative diplococci are not detected in the presence of microscopic evidence of urethritis, treatment for chlamydial infection alone is recommended.

Acute Disease↗
PubMedDate not supplied

Fine needle aspiration cytology of tubercular epididymitis and epididymo-orchitis.

OBJECTIVE: To study the role of fine needle aspiration cytology (FNAC) and ancillary studies in the diagnosis of tubercular epididymitis or epididymo-orchitis. STUDY DESIGN: Forty patients with tubercular epididymitis or epididymoorchitis diagnosed on FNAC underwent a detailed clinical workup, imaging and microbiologic studies before being started on antitubercular treatment (ATT). One patient underwent orchiectomy. RESULTS: Clinically, the disease presented in patients of all ages usually as a scrotal swelling or rarely as a scrotal sinus (3) or abscess (3) or as part of disseminated tuberculosis (2). Three patients gave a history of previous tuberculosis. Scrotal sonography confirmed the involvement of the epididymis, testis or spermatic cord in each case. FNAC was diagnostic in 27 aspirates (epithelioid cell granulomas with caseation) but nondiagnostic in the rest. Tubercular etiology was confirmed directly by detection of acid-fast bacilli (AFB) on FNA smears in 24 (60%) patients and urine samples in 11 and indirectly in 9 patients with negative AFB by using a combination of a positive Mantoux test (5 of 9), presence of caseating granulomas on FNA smears (7 of 9) and therapeutic response to ATT (9 of 9). CONCLUSION: FNA as a minimally invasive technique plays a prime role in the diagnosis of tubercular epididymitis and epididymoorchitis. It provides adequate material for cytologic and microbiologic examination and helps to avoid unnecesary orchiectomy.

Adolescent↗
PubMed1992

Surgical treatment of acute epididymitis and its underlying diseases.

Two hundred and seventy of 1,031 patients (26%) treated for acute epididymitis between 1979 and 1989 underwent surgery for their disease. Eighty percent of these interventions were therapeutic, 20% diagnostic to exclude testicular torsion or tumor. Diagnostic procedures detected underlying diseases that required surgery in 278/1,031 patients (27%). Two hundred and sixteen of these diseases caused lower urinary tract obstruction and were potentially responsible for the acute epididymitis. There were striking differences in type and frequency of the surgery performed depending on the patients' age. Surgery of epididymitis was almost exclusively diagnostic in patients of a young age (exclusion of testicular torsion) and almost always therapeutic in patients of an old age (abscess, prolonged disease). The rate of surgery for underlying diseases was the same for the young (55%) and old (62%) age groups. Obstruction of the lower urinary tract was the predominant cause for surgical treatment of underlying diseases, being mainly due to malformation in the young age group and due to acquired obstructive diseases in the old.

Acute Disease↗
PubMed1988

Molecular cloning of complementary deoxyribonucleic acid for an androgen-regulated epididymal protein: sequence homology with metalloproteins.

Acidic epididymal glycoprotein (AEG) is a 31,000 molecular weight secretory protein of the rat epididymis. Screening of a rat epididymal cDNA library with affinity-purified AEG antiserum yielded cDNA for AEG. Identity of the clones was verified by comparison of amino acid sequence of the purified protein with the sequence derived from the nucleotide sequence of the cDNA isolates. Two classes of AEG cDNA, approximately 1500 base pairs (bp) and 950 bp in length, differed by 538 bp in the 3'-untranslated region and by four single nucleotide mismatches, one of which was in the coding region. Northern blot hybridization of epididymal RNA revealed two species of AEG mRNA, corresponding in length to each type of cDNA. Analysis of RNA from individual animals provided evidence that the two mRNA species are the products of allelic genes. In vivo studies demonstrated that the level of total AEG mRNA is regulated by androgen. Amino acid sequence homology of AEG with metal-binding domains of several proteins suggests that AEG is a metalloprotein.

Amino Acid Sequence↗
PubMed2006

Trends in clinical encounters for pelvic inflammatory disease and epididymitis in a national sample of Australian general practices.

Trends in the frequency of clinical encounters for pelvic inflammatory disease (PID) and epididymitis in Australian general practice were determined via a national representative study of general practice activity between 1998 and 2003. Information was derived from 502,100 general practice encounters that occurred during the study period. An estimated 59,200 encounters for PID and 54,200 encounters for epididymitis took place in Australian general practice each year. Despite increases in national notification rates for Chlamydia trachomatis, over the study period overall encounter rates did not change significantly for either condition, and a fall in encounter rates for PID of about 50% occurred among women aged 15-34 years (P=0.02). Only 0.3% of encounters for PID and 1.9% of those for epididymitis resulted in hospital referral. On a population level, trends in the incidence of chlamydia-related diseases do not necessarily parallel those of reported chlamydia rates.

Adolescent↗
PubMed2001

Analysis of epididymal proteins during sexual maturation in male albino mice.

Androgen dependent epididymal proteins act as antigen to produce autoantibodies and affect normal fertility. In the present study, epididymal proteins were analyzed during the time of sexual maturation and their androgen dependency was studied in male albino mice. Epididymis of 21 days (Pre-pubertal), 45 days (Pubertal), 60 days (Post-pubertal), orchidectomized (15 days after surgery) and orchidectomized with testosterone-treated (15 days after treatment) mice were dissected out and analyzed. Caput, corpus and cauda epididymidis were separated and the protein extract was prepared with 0.1 M PBS for 10% SDS-PAGE analysis. Testosterone assay was performed in the experimental groups except the testosterone treated group. The electrophoretic analysis of proteins in caput, corpus and cauda epididymidis of orchidectomized animals showed the disappearance of several proteins as compared to the adult. However, the disappeared proteins started to reappear in testosterone treated animals. The results suggest that removal of testis depletes the testosterone level and causes significant alteration in epididymal proteins. These proteins need further investigation for the purpose of immunocontraception by using them as antigens.

Animals↗
PubMed2000

The lipocalin sperm coating lizard epididymal secretory protein family: mRNA structural analysis and sequential expression during the annual cycle of the lizard, Lacerta vivipara.

The epididymal epithelial cells of the lizard (Lacerta vivipara) produce large amounts of specific proteins under androgenic control. Amongst them, a major protein family that binds to the head of spermatozoa, the lizard epididymal secretory protein (LESP) family, has been identified as a member of the lipocalin superfamily. LESPs are composed of 9 elements that present an identical molecular mass of 18 000 Da but have a large range of pHi (3.5 to 9). The structural analysis of this protein family was performed by the determination and comparison of both the aminoterminal sequence of each element and the complete sequence of three specific LESP cDNA clones. When not identical, LESP elements present randomly dispatched nucleotide and amino acid substitutions, indicating the existence of at least five LESP mRNA populations encoded by a multigenic family. We determined that these LESP genes are differentially expressed during the annual epididymal cycle.

Amino Acid Sequence↗
PubMedDate not supplied

Effect of early antibiotic treatment on the formation of sperm antibodies in experimentally induced epididymitis.

This investigation was conducted to evaluate whether or not experimentally produced epididymitis could induce the development of cytotoxic sperm antibodies and if effective antibiotic therapy could reverse the development of immunity to sperm. Escherichia coli was injected into the tail of the epididymis in adult Lewis rats to induce epididymitis and was allowed to incubate for 24 h, 72 h, 8 days, or 15 days. Serum titers of cytotoxic sperm antibodies at these time intervals were determined. Sperm antibody titers began to rise 3 days after inoculation, peaked, and plateaued at 8 days. The titers were negligible in the control rats. Two other groups of rats were inoculated with E. coli in a similar manner and were treated with tetracycline 25 mg/kg/day starting at either 24 h or 8 days after inoculation, for 7 days. The antibody titers became negligible in these two treated groups, the results being statistically significant when contrasted with the infected but untreated groups (p < .001 and < .05, respectively, for the 24-h and 8-day groups). However, histological examination of the antibiotic-treated and untreated specimens revealed significant inflammation and infection of the epididymis in both treated groups. Testicular alterations were consistent in both groups. It is concluded that epididymitis consequent to infection with E. coli can induce cytotoxic antibody formation in Lewis rats. Treatment with appropriate antibiotics may suppress the antibody response either through a direct immunosuppressive effect of the antibiotic or through a decrease in the antigenic load of killed sperm secondary to eradication of the infection.

Animals↗
PubMedDate not supplied

Treatment of tuberculous epididymitis by intratunical rifampicin injection.

The results of treating 4 patients with tuberculous epididymitis by rifampicin injection into the tunica vaginalis sac were compared with the results in another 4 patients treated with the common oral antituberculous drugs. Oral treatment consisted of daily administration of rifampicin (600 mg), isoniazid (300 mg), and ethambutol (25 mg/kg body weight). Rifampicin (600 mg) was injected intratunically every 4 to 6 days. Treatment continued for 6 months in both groups, with 3 months follow-up thereafter. Periodic clinical assessment as well as semen and hydrocele fluid examination were performed. In the intratunical injection group, epididymal swellings disappeared in 3 to 6 months; semen and hydrocele fluid became sterile in 4 months. The oral group showed partial diminution of the epididymal mass in one patient only; one patient developed scrotal fistula. Semen remained positive for tubercle bacilli, and hydrocele fluid became negative in one patient only. The satisfactory results with the intratunical rifampicin administration seem to be due to the drug reaching the epididymis in high concentrations. The tunica vaginalis is a part of the peritoneum and, like it, is believed to have a high absorptive power. Furthermore, the intratunical injection treatment uses a single drug, in contrast to the oral therapy, which, by its multidrug administration, enhances the incidence of side effects.

Adult↗