Tuberculous Epididymitis and Epididymo-orchitis

Muttarak, M; Peh, Wilfred C.G.; Lojanapiwat, B; Chaiwun, Benjaporn

doi:10.2214/ajr.176.6.1761459

Cited by 98 publications

(108 citation statements)

References 8 publications

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“…The testis is usually not involved as frequently as seen with acute epididymo-orchitis, but areas of focal low echogenicity, mimicking intra-testicular tumours, may be seen. As with the acute form, scrotal wall thickening, hydrocele and abscesses may occur [27].…”

Section: Epididymitismentioning

confidence: 99%

A review of ultrasound imaging in scrotal emergencies

Yusuf

Sidhu

2013

J Ultrasound

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Scrotal emergencies represent a small proportion of admissions to the emergency department; however, the intimate nature and potential for serious outcome often cause great anxiety. Rapid assessment is required to exclude fertility-threatening conditions and expedite surgical management. Ultrasound is an essential tool in acute scrotal assessment as it allows rapid, radiation-free, highresolution imaging and, importantly, assessment of vascularity with colour Doppler imaging. In the presentation of the acute scrotum, the ''on-call'' practitioner will frequently be asked to exclude pathology requiring surgical management, in particular torsion of the spermatic cord. To provide an accurate evaluation the individual is required to have an understanding of scrotal anatomy, sonographic technique and recognition of pathology. This review article will familiarise the reader with the sonographic findings of common acute scrotal pathology.Sommario Le emergenze scrotali rappresentano una piccola percentuale di accessi al pronto soccorso, ma la natura intima e la possibilità di esiti seri sono spesso causa di grande ansia. E' necessaria una valutazione rapida, al fine di escludere condizioni di pericolo per la fertilità e accelerare il trattamento chirurgico. L'ecografia è uno strumento essenziale per la valutazione dello scroto acuto in quanto rapida, esente da radiazione, ad alta risoluzione e, soprattutto, permette la valutazione della vascolarizzazione con colour Doppler. Nello scroto acuto l'ecografista spesso verrà chiamato a escludere patologie che richiedono un trattamento chirurgico, in particolare la torsione del funicolo spermatico. Al fine di fornire una valutazione precisa è tenuto ad avere una conoscenza dell'anatomia scrotale, della tecnica ecografica e a conoscere le varie patologie. Questo articolo di revisione ha lo scopo di familiarizzare il lettore con gli aspetti ecografici della patologia scrotale acuta più frequente.

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Section: Epididymitismentioning

confidence: 99%

A review of ultrasound imaging in scrotal emergencies

Yusuf

Sidhu

2013

J Ultrasound

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Section: Discussionmentioning

confidence: 99%

“…[2][3][4] It is initially localized in the epididymis, especially in the tail, because of its irrigation characteristics and because it is the first area reached by the reflux via the vas deferens. 3 Unless suitably treated with antituberculous drugs, it may later involve the rest of the epididymis and the testicle. [1][2][3] Clinically, the symptoms involve an enlarged scrotum, with or without pain, possibly simulating tumors, torsion, bacterial orchiepididymitis, sarcoidosis, leprosy, brucellosis, or syphilis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculous Orchiepididymitis After BCG Therapy for Bladder Cancer

Briceño-García

Gómez-Pardal

Alvarez-Bustos

et al. 2007

Journal of Ultrasound in Medicine

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crotal infection with Mycobacterium tuberculosis is unusual, occurring in about 7% of patients with tuberculosis, 1 although its incidence is increasing worldwide in association with human immunodeficiency virus infection. We report a rare case of tuberculous orchiepididymitis in a patient who received intravesical instillation therapy with BCG vaccine after bladder tumor resection and describe the benefits of Doppler sonography for the study of orchiepididymitis.Received March 16, 2007, from the Radiology Service (E.M.B.-G., A.G.-P., G.A.-B., I.A.-M., M.M.M.) and Emergency (R.S.-V.) and Pathology (V.M.-R.) Departments, Carlos Haya Hospital, Malaga, Spain. Manuscript accepted for publication March 26, 2007. Address correspondence to Eva M. Briceño-García, MD, C/ Lingüista Manuel Seco 3, 29016 Malaga, Spain. E-mail: evambriceno@hotmail.com Case ReportThe patient was a 75-year-old man who underwent transurethral resection of a bladder tumor (grade 3, noninvasive papillary urothelial carcinoma) and benign prostatic nodular hyperplasia. One month later, he started adjuvant therapy with intravesical instillations of BCG: an induction phase of 1 instillation weekly for 4 weeks with 25 mg of InmuCyst (Aventis Pasteur, Lyon, France) followed by monthly booster instillations. Two weeks after the first booster dose, he had pain and tumefaction of the right scrotum. Conventional treatment was given with nonsteroidal anti-inflammatory drugs and antibiotics, ciprofloxacin for 2 weeks and amoxicillin-clavulanic acid for another 2 weeks, resulting in slight improvement of the symptoms and the inflammation, although the testicle and epididymis remained enlarged. The patient underwent a sonographic study with a Philips SD800 7.5-MHz transducer (Philips Medical Systems, Bothell, WA), which showed an enlarged right epididymis, especially the tail, with heterogeneous hypoechogenicity (Figure 1). A hypoechoic nodule was detected on its head. The lower portion of the testicle was also hypoechoic, with the epididymal tail poorly outlined. Color Doppler imaging showed no notable increase in the vascularization of the nodules.

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“…If abnormalities on testicular examination were noted, a testicular ultrasound would be indicated. Tuberculous infection of the epididymitis can lead to massive dilatation of the organ (25), and aspiration of epididymal contents for culture could be performed. If tuberculosis were diagnosed, treatment with isoniazid and rifampin for 9 months would be recommended; however, this therapy would be unlikely to reverse obstructive azoospermia, given the scarring of the epididymis resulting from the infection (26).…”

Section: Fertility and Sterilitymentioning

confidence: 99%

George Washington's infertility: why was the father of our country never a father?

Amory

2004

Fertility and Sterility

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Tuberculous Epididymitis and Epididymo-orchitis

Cited by 98 publications

References 8 publications

A review of ultrasound imaging in scrotal emergencies

A review of ultrasound imaging in scrotal emergencies

Tuberculous Orchiepididymitis After BCG Therapy for Bladder Cancer

George Washington's infertility: why was the father of our country never a father?

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