Introduction
After having carefully examined the general characteristics of the epididymitis, the classification, the main etiological agents and the symptomatological profile that derives from it, in this resolutive article the possible therapies necessary to definitively redeem the patient from epididymitis, after having meticulously analyzed the diagnostic picture of the disorder in question.
Diagnosis of epididymitis
As soon as the first symptoms of epididymitis occur (pain or tension in the testicle, pain in the groin), it is advisable to consult the doctor, who, to draft the diagnosis, proceeds first with physical examination and palpation of the testicle, to then carry out a more detailed investigation by rectal exploration, useful for checking the conditions of the vesicles and ascertaining - or denying - a hypothetical enlargement of the prostate. In general, to draw up the diagnosis, the urologist also prescribes blood and urine tests to the patient, useful to confirm or not the presence of a bacterial infiltration.
If the clinical picture is not yet clear, despite the aforementioned diagnostic tests, the doctor can also recommend a testicular CT scan, an ultrasound scan and screening for venereal diseases.
The CT scan is important to remove the hypothesis of the twisted testicle (topic already discussed in the previous article): this test, to which the affected patient is subjected, is carried out through an intravenous injection of a radioactive pharmacological substance, useful to highlight - through specific equipment - both the testicular areas with the most blood and the ones that receive the least. Generally, the abundant blood flow in some areas of the testicle is synonymous with epididymitis; vice versa, when poorly sprayed, the chances of a testicular torsion increase.
Ultrasound, a clearly non-invasive examination, is useful for highlighting the internal anatomical structures: the patient hypothetically suffering from epididymitis is subjected to this simple diagnostic test to exclude testicular neoplasms and, sometimes, even testicular torsion.
Finally, screening for venereal diseases is performed by taking a sample of fluid in the urethra (through the insertion of a thin swab in the penis): the examination is based on the search for pathogenic bacteria. This test, at first sight not benevolently accepted by the patient, proves to be very useful for identifying the etiological agent, therefore choosing the most suitable pharmacological treatment to eradicate the beating.
Therapy
To learn more: Epididymitis symptoms
The therapy aimed at treating acute forms of epididymitis includes, mainly:
- The administration of antibiotics aimed at that particular pathogen (eg, ofloxacin, doxycycline, etc.)
- The implementation of therapeutic aids, such as the administration of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs, useful in the case of non-bacterial epididymitis), scrotal elevation and the application of ice directly to the scrotum level (for severe inflammatory forms) . In some cases of severe severity, the patient is hospitalized to monitor the progression of the infection and the response to treatment.
- When the pain is excruciating, opioid administration is even required.
- If the therapies just listed were not effective, the operation represents a necessary alternative: the intervention is known as a ligation of the vein (vasectomy), in which an injection of a pharmacological mix (analgesics, steroids, NSAIDs) is practiced. level of epididymal nerve. Following this delicate medical maneuver, the area affected by the pain heals: healing, unfortunately, is only temporary, since most of the time, the "pseudo-anesthetic" effect lasts for two or three months. After this period, the pain tends to recur with the same intensity as the previous time: to remedy it, the patient will have to undergo surgery again, so that the symptoms of epididymitis slowly regress.
If the pain continues to recur frequently, despite repeated interventions, partial or total excision of the epididymis (epididymectomy) is recommended, which represents the choice of excellence in case of scrotal abscess.
If the epididymitis was caused by a sexually transmitted disease, the partner should also undergo antibiotic treatment.
Reduce pain
It is the duty of the physician to explain to the patient all the possible dangers he could incur by not undergoing specific therapy; however, it is useful to apply some simple prophylactic rules to relieve pain. The patient suffering from epididymitis should remain in bed, in a stretched position: by doing so, the tissue tension is lost and the subject relaxes. Also the on-site applications of ice on the scrotum are effective, since they generate a mild analgesic and flaming effect; obviously, total abstention from sexual intercourse is recommended until the bacteria responsible for the epididymitis will be eliminated and the infection completely cured.
However, in most cases, epididymitis is an easily treatable disease, even only with antibiotics, when diagnosed early; however, the doctor's opinion is always fundamental.
