Changes in the Testis Parenchyma Caused by Acute Nonspecific Epididymitis

Nilsson, S.; Obrant, Karl Ola; Persson, Petra

doi:10.1016/s0015-0282(16)36789-9

Cited by 45 publications

(17 citation statements)

References 5 publications

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“…Genitourinary involvement in human brucellosis raises the possibility of sexual dissemination . Misdiagnosis leading to irrational therapies in this syndrome may result in serious genitourinary complications, including abscess formation , infarction , atrophy , suppurative necrosis , failure of spermatogenic function, infertility and testicular loss in a significant portion of cases . In this study, 90% of the patients were male and 93% of them experienced epididymitis and/or orchitis.…”

Section: Discussionmentioning

confidence: 66%

Genitourinary brucellosis: results of a multicentric study

Erdem

Elaldı

et al. 2014

Clinical Microbiology and Infection

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This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530±3115/mm3. Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.

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Section: Discussionmentioning

confidence: 66%

Genitourinary brucellosis: results of a multicentric study

Erdem

Elaldı

et al. 2014

Clinical Microbiology and Infection

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“…Giamerellou et al (1984) has shown that chronic prostatitis is often associated with oligoasthenoteratozoospermia (OAT) and that long-term antibiotic treatment not only cured the prostatitis but also normalized or improved the spermatograms in 70% of the patients. However, it is likely that the presence of a chronic bacterial infection, over an extended period, predisposes the host for intracanicular spread to the rest of the reproductive tract with negative consequences for sperm quality, resulting from ductal stenosis (Schoysman, 1981) and subclinical orchitis (Nilsson et al, 1968). Our own study of 50 men, in whom the prostatitis was verified by rectal ultra----sonography, indicated that a large number had disturbances in sperm quality including azoospermia ( Fig.…”

Section: -mentioning

confidence: 87%

Infection in the male reproductive tract. Impact, diagnosis and treatment in relation to male infertility

Purvis¹,

Christiansen²

1993

Int J of Andrology

177

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The following are the conclusions that can be derived from a review of the literature regarding the role of infection in the aetiology of male infertility. (i) Temporary inflammatory episodes in the male reproductive tract which are self-limiting are probably common. (ii) Caution should be exercised in the use of leukospermia or bacteriospermia as parameters for glandular infection. (iii) There is a need for alternative techniques for detecting non-symptomatic deep pelvic infections in the male; one technique of great promise is rectal ultrasound. (iv) Rectal ultrasound indicates that a large number of men with poor sperm quality have a non-symptomatic, chronic prostatovesiculitis. (v) Increasing evidence implicates Chlamydia trachomatis as being a major cause of chronic non-bacterial prostatitis. (vi) An important aspect of chlamydial infections in men may be that the male accessory sex glands may function as reservoirs for the organism, increasing the probability of infection in the female. (vii) Ureaplasma urealyticum may also play an important aetiological role in male infertility but its significance is confounded by its acknowledged function as a commensal in the reproductive tract. (viii) One of the manifestations of male reproductive tract infection is the induction of sperm autoantibodies. (ix) There is a need for more systematic controlled studies of the effects of antibiotic treatment on sperm quality with different preparations for extended periods using patient groups in which a glandular infection has been verified, e.g. by rectal ultrasonography.

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“…The relationship between acute epididymitis and subfertility in men is poorly understood. Involvement of the testis by inflammation causes decreased spermatogenesis during acute epididymitis [10], and subsequent reduced spermatogenesis is a frequent consequence [85]. However, the incidence of long‐term subfertility after unilateral testicular involvement is unclear [86].…”

Section: Outcomes and Complicationsmentioning

confidence: 99%