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Ascending spread of urethral pathogens may be the mechanisms of infection of the prostate and epididymis. Sexually transmitted organisms cause most epididymitis in young men. Although evidence is mounting to suggest that sexually transmitted organisms may cause prostatitis, data are insufficient at this time to base a therapeutic approach on this concept. The authors present approaches to the management of these two disorders.
To better document the detrimental effect of ram epididymitis (RE) in large range flocks, a study was conducted to determine the correlation of palpable RE lesions and semen quality. Presence of leukocytes in the semen of rams affected with RE also was evaluated and found to correlate positively with RE lesions and inversely with semen quality. Rams with palpable RE lesions usually produced semen of reduced quality; however, some affected rams did produce good quality semen. The mean scrotal circumference varied significantly when rams were analyzed by breed, but not when grouped by RE status or classified by semen quality.
Scrotal palpation, microscopical examination of semen smears and the application of bacteriological techniques, revealed the incidence of Actinobacillus seminis and Brucella ovis infection of rams in the central and southern districts of the Orange Free State to be 2,9% and 4,3%, respectively. More Dorper than Merino rams were affected. Although clinically detectable epididymitis was found in 5,9% of rams examined, infection with A. seminis and B. ovis, as measured by the presence of neutrophils in semen and positive semen cultures, could only be demonstrated in a small minority of affected cases. These organisms were found more regularly in clinically negative rams excreting neutrophils in their semen. Possible reasons for the high incidence of sheep brucellosis in rams in the particular area as well as the higher incidence of infection in Dorper rams are discussed.
Epididymitis after operations on the vesical cervix is of canicular or lymphohaematogenous origin. The latter form is at present not absolutely avoidable. For aetiological reasons TUR has a clearly greater effect as a method of vasoresective prophylactive than open surgery. Relevant statistics are referred to.
Testicles from rams in flocks experiencing ram epididymitis in Idaho and eastern Oregon were cultured. Twenty-six breeding rams from 6 flocks were cultured and only Brucella ovis was isolated. Virgin rams (65) harbored numerous species of small fastidious gram-negative rods, including Actinobacillus actinomycetemcomitans, Haemophilus spp, Moraxella spp, and Pasteurella spp. Thus, there appeared to be 2 separate disease entities, dependent on sexual experience of the animal.
Electron microscope studies were carried out on the ultrastructural changes in the testis and the epidiymis of rams affected with infectious epididymitis, manifesting a pronounced clinical picture. The following conclusions were drawn: 1. The changes in the seminiferous tubules are characterized by a strongly expressed sensitivity of the cells at all levels. Noticeable are disturbances in the normal structure of the nuclear substance of both spermatogonia and spermatocytes, vacuolation of the nucleus and the cytoplasm, disrupture of the nuclear and cell membranes, decapitation of spermatids and spermatozoa with expressed lysis phenomena, and free lipid drops in the lumen. 2. The ultrastructural changes in the epididymis tubules resemble those in the seminiferous tubules: degeneration and desquamation of the ciliated epithelium, occasional disrupture of the basal membrane, and hemorrhages. The cell content of the lumen, beside the presence of pathologic spermatozoa, is admixed with leukocytes and Brucella ovis cells.
A case of tuberculous epididymitis which presented as an acute hydrocele is reported and the relevant literature reviewed. The patient had undergone contralateral orchidectomy 20 years previously for the same condition associated with pulmonary tuberculosis. The most recent episode followed unrelated illness; the diagnosis was confirmed after surgical intervention and cure was achieved with adjuvant chemotherapy. Although rare, genital tuberculosis should still be considered in cases of scrotal swelling when there is a history of previous tuberculous disease or exposure.
Acute scrotum in children frequently causes diagnostic difficulties. Instantaneous treatment is essential especially in cases of torsion of the testis. Acute epididymitis (AE) is relatively frequent also in prepubertal boys but is probably underdiagnosed. Two cases and a review of AE and the differential diagnoses towards other acute scrotal diseases are presented. It is stressed that immediate diagnosis and treatment is important, and that referral to hospital is mandatory.
The epididymitis is an infection due frequently to the Chlamydia trachomatis. The recent works explain the importance and severity of the affection by a local reaction of delayed hypersensibility analogue to the evolution of the tuberculosis.
The present study reports our experience with epididymitis in 18 boys aged 3-16 years. The diagnosis was made at surgical exploration in 12 patients under 10 years. In the remaining 6 patients over 11 years, the diagnosis was made on the clinical and scrotal ultrasound findings. All patients were treated with analgesics, ice bags, scrotal support and antibiotics. Children that consult for scrotal pain should undergo surgical exploration within 6 hours from the onset of pain if imaging by echo Doppler or technetium pernectate is unavailable.
Changes of parameters of cell immunity in the process of treatment of patients with acute epididymitis were studied. They were presented by three groups depending on the methods of therapy: surgical and conservative ones with the application of UHF or laser irradiation. The recovery of functions of the immunity system was peculiar to patients previously subjected to surgical treatment. However, most pronounced immuno-correcting effect was characteristic of patients given laser therapy.
Amiodarone-induced chemical, sterile epididymitis has previously been reported. We present 2 cases who were on amiodarone therapy for refractory cardiac arrhythmia. Recognition of this side effect and treatment by lower drug dosage can prevent unnecessary antibiotic therapy and invasive urological procedures.
Cytomegalovirus (CMV) infection, though usually systemic, has been known to cause localised involvement of organs like lung, liver, testis and gastrointestinal tract. We report a case of cytomegaloviral infection involving the epididymis without systemic manifestations in an young male one month after renal transplantation. The diagnosis was made on histopathologic examination of the epididymo-orchidectomy specimen. Clinical improvement occurred after the emergency epididymo-orchidectomy. To the best of our knowledge, only three cases of CMV epididymitis have been described in the world literature--two in transplant patients and one in an AIDS patient.
Spermatozoa mature during epididymal transit, acquiring the abilities to swim progressively, fertilize oocytes, and produce viable offspring. In this study, we investigate the capacity of spermatozoa retrieved from the midcorpus and distal cauda regions of the epididymis of the cynomolgus monkey to penetrate homologous zona pellucida. Successful in vitro fertilization by ejaculated macaque sperm is dependent upon the addition of caffeine and dbcAMP. Therefore, the effect of these cyclic nucleotide mediators was also examined in this study. Results of sperm motion analysis indicate no difference in baseline values (without stimulators) for any motion parameter. With the addition of caffeine and dbcAMP, curvilinear velocity significantly increased only for the distal cauda sperm (P = 0.05). Amplitude of the lateral head displacement was significantly increased for distal cauda sperm (P < 0.01); although elevated above baseline, the increase observed after activation by corpus sperm was significantly lower than that achieved by cauda sperm (P < 0.05). The addition of caffeine and dbcAMP was an absolute requirement for zona penetration by both midcorpus and distal cauda sperm. With activation, zona penetration was significantly decreased for corpus sperm compared to cauda sperm (P < 0.001). These results suggest that cynomolgus monkey sperm reaching the midcorpus region of the epididymis have not completed all of the maturational changes requisite for successful fertilization; this immaturity is evidenced by decreased sperm motion and by impedance at the level of zona penetration.
Using a combination of gel filtration and hydroxyapatite chromatography, a major secretory glycoprotein (EP140) was purified from rabbit epididymal fluid. The protein had an apparent Mr of approximately 140 kDa under native conditions but dissociated into 2 equimolar amounts of glycosylated subunits, alpha and beta of Mr 35 and 33 kDa, upon sodium dodecylsulfate polyacrylamide gel electrophoresis in absence of reducing agents. Thus EP140 appears to be a tetramer composed of 2 alpha and 2 beta subunits, held together by noncovalent forces. Proteolytic peptide mapping, amino acid analysis, and determination of partial amino acid sequences suggested that the 2 subunits were very similar, differing only at some punctual residues in their primary structures. The amino acid sequences obtained did not show significant similarity to any known protein. Western blot determinations with a specific antibody indicated that no EP140-immunorelated protein was detected either in testis or blood from the rabbit nor in epididymides from rats or hamsters. EP140 was shown to associated to the spermatozoon surface, mainly at the acrosomal zone and in the middle piece, and this association progressively increased during the transit of the spermatozoon through the epididymis.
Sialoprotein "anti-agglutinin," previously shown to inhibit sperm head-to-head agglutination, is found in both boar epididymal and seminal plasma. The present report characterizes anti-agglutinin by mass spectrometry, by N-terminal amino acid sequence analysis, and by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) and Western blotting techniques to assess phosphate content of the molecule. Anti-agglutinin had the SDS-PAGE mobility of approximately 25 kDa. By electrospray ionization-mass spectrometry, however, mass spectra of anti-agglutinin were characterized by two major peaks (19,379-19,382 Da and 19,395-19,397 Da) and several minor peaks. Mass spectrometry of tryptic peptide fragments of deglycosylated anti-agglutinin and amino acid sequence analysis revealed that the protein has a unique peptide-mass fingerprinting of fragments (12,668 Da, 5,209 Da, 1,226 Da, and 1,168 Da) and a novel N-terminal amino acid sequence (KTDDY AISGA KEEEF YDYME ELYAV), respectively. Additionally Western blot techniques, using commercially available monoclonal antibodies, were used to detect presence of phosphothreonine and phosphoserine substituents, but two different monoclonal antibodies did not detect phosphotyrosine. Moreover, treatment with two different alkaline phosphotases converted the molecule, as assessed by SDS-PAGE and detection by silver stain, from the parent form of about 25 kDa to forms of approximately 19 kDa (similar to that assigned by mass spectrometry) and/or 15 kDa. Original antiserum generated toward, and reacting with native anti-agglutinin, reacted only with 19 kDa form. These results are consistent with the conclusion that the native anti-agglutinin may be a novel protein that is phosphorylated at serine and/or threonine residues.
An aqueous extract of Cynomorium coccineum was administered by stomach tube to ten mature male Wistar rats, at a dose of 47 mg/100 kg body weight/day for 14 consecutive days. Ten rats were kept as controls and received normal saline by oral route at the same dosing interval. Sperm was collected from the epididymes after decapitation. The results revealed that the water extract of the Cynomorium coccineum induced significant increase in the sperm count, improved the percentage of live sperm and their motility and decreased the number of abnormal sperm. Testicular histology showed increased spermatogenesis and seminiferous tubules full of sperm in the treated group compared with the controls.
Morphologic and morphometric sperm characteristics of mouse epididymal extracts from animals exposed to static magnetic fields were evaluated. For this purpose, animals were exposed for 35 days to a field of 0.7 T generated by a commercial permanent magnet for either 1 or 24 h per day. The values of morphometric parameters were obtained using the morphometric module of the Sperm Class Analyzer computerized image analysis system, and percentages of abnormalities were calculated. The size of sperm heads was unaffected by exposure to static magnetic fields. Lack of hook was a sperm head abnormality found significantly more frequently in animals exposed continually than in nonexposed animals, showing a possible alteration to the spermatogenic process after exposure to static magnetic fields. The percentage of sperm with coiled tails or of sperm with abnormal midpiece or tail was not altered by exposure.