Surgical T reatment of Acute Epididymitis and Its Underlying Diseases

Höppner, Wolfgang; Strohmeyer, T.; Hartmann, Michael; D, López-Gamarra; Dreikorn, K.

doi:10.1159/000474759

Cited by 32 publications

(29 citation statements)

References 9 publications

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“…In contrast to younger men where sexually transmitted pathogens are predominant, in older patients with a history of subvesical obstruction, E. coli is the most frequent pathogen responsible [2,3]. Immediate sequelae such as abscess formation are estimated to require surgical treatment in ª 10% [3,7] to 20% [6], depending on the antimicrobial agent used for therapy [7]. Development of chronic pain may require epididymectomy, with a questionable outcome [18].…”

Section: Discussionmentioning

confidence: 99%

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Experimental Escherichia coli epididymitis in rats: a model to assess the outcome of antibiotic treatment

Ludwig

Johannes

Bergmann³

et al. 2002

BJU International

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Objective To assess the effect of initial antimicrobial therapy with a new highly potent quinolone (sparfloxacin) on the outcome of infection, especially acute and chronic inflammation, in a rat model of unilateral Escherichia coli epididymitis. Materials and methods The study included 60 SpragueDawley rats, each of which received 0.1 mL of an E. coli (0:6 strain) suspension (10 6 colony forming units/mL) injected into the right ductus deferens. At 24 h after infection an oral antimicrobial treatment with sparfloxacin was initiated in half of the animals. The rats were killed 14 days, 3 and 6 months after infection, and both epididymes and the prostate gland cultured to re-isolate E. coli . To evaluate the grade of inflammation in both epididymes, histological variables, including acute and chronic inflammation and scar formation, were evaluated and a total inflammatory score, representing the sum of all variables, computed. Results Whereas antimicrobial therapy eradicated the pathogen, in untreated animals the pathogen was detectable for up to 6 months after infection in the infected epididymis and/or the prostate gland, while the contralateral epididymis was sterile. The inflammatory reaction in the infected epididymis was significantly less in treated animals ( P < 0.001). Subclinical nonbacterial inflammation was present in the contralateral epididymis. Conclusions Although adequate antimicrobial treatment eradicated the pathogen and reduced the grade of epididymal damage, inflammation was not avoided. Subclinical inflammation of the contralateral epididymis may contribute to impaired fertility. These results indicate that an inflammatory reaction initiated by bacteria might persist as a nonbacterial process despite early therapy, or by bacteria undetectable by conventional culture techniques, and may compromise male fertility.

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Section: Discussionmentioning

confidence: 99%

“…One severe complication of acute epididymitis is impaired fertility, even when clinically the disease is unilateral [4,5]. Also, abscess formation and chronic pain may require surgical treatment [3,6].…”

Section: Introductionmentioning

confidence: 99%

Experimental Escherichia coli epididymitis in rats: a model to assess the outcome of antibiotic treatment

Ludwig

Johannes

Bergmann³

et al. 2002

BJU International

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“…The retrograde ascent of pathogens is the usual cause of epididymo-orchitis. Sexually transmitted Neisseria gonorrhoeae or Chlamydia trachomatis pathogens are the most common causes of epididymo-orchitis in men aged 14 to 35 years, whereas Escherichia coli pathogens along with urinary tract infection constitute the most common cause in men younger than 14 years and older than 35 years of age [14–17]. …”

Section: Discussionmentioning

confidence: 99%

Patients with Epididymo-Orchitis and Meteorological Impact in Taiwan: A Nationwide Population-Based Study

Liu

Chang

et al. 2017

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Epididymo-orchitis is a common infectious disease among men, especially men aged 20 to 39 years. The aim of this study was to analyze possible associations of various meteorological indicators on the incidence of epididymo-orchitis in Taiwan. Methods and Materials. This nationwide population-based study collected data on cases of epididymo-orchitis that were newly diagnosed from 2001 to 2013 in Taiwan. Monthly meteorological indicators, including average temperatures, humidity, rainfall, total rain days, and sunshine hours, were collected from the Central Weather Bureau of Taiwan. Data for a total of 7,233 patients with epididymo-orchitis were collected for this study. Results. The monthly incidence of epididymo-orchitis was positively correlated with temperature, rainfall, and sunshine hours. The average monthly temperature had a linear correlation with the incidence of epididymo-orchitis (ß = 0.11). The monthly average temperature is significantly related, with a positive linear correlation, to the incidence of epididymo-orchitis in Taiwan. Conclusion. This finding may constitute useful information in terms of helping physicians to distinguish between patients with epididymo-orchitis and testicular torsion in hot or cold weather.

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“…There are several theories including reflux of infected urine into the ejaculatory duct, chemical irritation from sterile urine reflux or from drugs (eg amiodarone), 18 haematogenously spread infection (viraemia or bacteraemia) and direct viral causes. 17,[19][20][21] In recurrent epididymitis, a genitourinary abnormality not previously detected should also be suspected. 22 Bennett et al demonstrated a statistically significant higher occurrence of AE in uncircumcised children.…”

Section: Aetiologymentioning

confidence: 99%

The aetiology and current management of prepubertal epididymitis

Gkentzis

Lee

2014

annals

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INTRODUCTION The aim of this study was to review the published evidence on the pathogenesis and management of acute epididymitis (AE) in prepubertal boys after the authors encountered an unexpectedly large number of such cases in their institution. METHODS Using MEDLINE ® , a literature search was performed for articles in English with the words "pre-pubertal" OR "boys" OR "p(a)ediatric" OR "children" AND "epididymitis" OR "epididymo-orchitis". RESULTS The literature suggests that it is rare to find a bacterial infection or anatomical anomaly as a cause for AE in this population. A postviral infectious phenomenon is the most likely explanation. The management should be supportive and antibiotics reserved for those with pyuria or positive cultures. Urodynamic studies and renal tract ultrasonography have been advocated for those with recurrent epididymitis. CONCLUSIONS AE in prepubertal boys is more common than believed previously. A careful history for recent viral illnesses should be included. Antibiotics, urinary tract imaging and functional studies should be used in selected cases.

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Surgical T reatment of Acute Epididymitis and Its Underlying Diseases

Cited by 32 publications

References 9 publications

Experimental Escherichia coli epididymitis in rats: a model to assess the outcome of antibiotic treatment

Experimental Escherichia coli epididymitis in rats: a model to assess the outcome of antibiotic treatment

Patients with Epididymo-Orchitis and Meteorological Impact in Taiwan: A Nationwide Population-Based Study

The aetiology and current management of prepubertal epididymitis

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