epididymitis

What is epididymitis?

Among the pathologies of the male genital tract, the epididymitis is classified among the "scrotum disorders": despite being a rather sporadic condition, it must not be forgotten, since, as we will see during the disquisition, the epididymitis could degenerate, therefore create serious complications.

The term epididymitis consists of a suffix –ite, a Greek ending that indicates an inflammatory process: the prefix refers to the epididymis, that thin, long and twisted duct on itself, which joins each testicle to its deferent duct. Epididymitis therefore indicates an inflammation of the epididymis.

Causes

Most often, the cause responsible for epididymitis goes back to a bacterial infection, but it is not uncommon for an aseptic status to cause inflammation of the epididymis.

Generally, the epididymitis caused by bacterial infiltration (especially E. coli ) follows other predisposing disorders, such as bacterial prostatitis or urethritis: strictly speaking, it is clear that this chain of events can aggravate the pre-existing condition. In the case of bacterial prostatitis, the occurrence of epididymitis increases even more when an energetic prostate massage is performed, which is responsible for the retrograde discharge of the fluids infected through the vas deferens.

Urine reflux within the epididymis is the most frequent cause of chemical epididymitis, generated by extreme physical exertion, weight lifting or other sports carried to excess.

Other causes responsible for epididymitis reside in venereal diseases, such as. for example, chlamydia and gonorrhea; however, fungal infections (eg Candida albicans ) are only rarely linked to the manifestation of epididymitis.

Furthermore, some interventions on the male genital-urinary tract (eg prostectomy, catheters, etc.) can be a contributing cause of the epididymitis.

Also the renal and bladder dysfunctions could be somehow related to the epididymitis: just think of tuberculosis infections, particularly alarming pathologies: in similar situations, when kidneys are affected, pathogenic microorganisms tend to spread through the urinary tract, until reaching near the posterior urethra and the bladder, to then expand to the prostatic level, to the vas deferens, to the epididymis and to the testicles.

Epididymitis can be a consequence of the administration of some pharmacological specialties, including Amiodarone, a drug used in the treatment of cardiac arrhythmia: among the possible side effects, inflammation at the level of the epididymis, which can be cured, is also remembered. in this case, modulating the dosage of the drug or suspending the treatment of the same. In such circumstances, it is still necessary to inform the doctor.

Predisposing causes of epididymitis

• Bacterial prostatitis / urethritis → bacterial infiltration → inflammation of the epididymis
• Bacterial prostatitis → energetic prostate massage → retrograde discharge of fluids infected through the vas deferens → epididymitis
• Extreme physical exertion, weight lifting → urine reflux inside the epididymis → chemical epididymitis
• Chlamydia and gonorrhea → inflammation of the epididymis
• Tuberculous infections → pathogenic microorganisms tend to spread via the urinary tract → epididymitis
• Administration of some pharmacological specialties → side effect: epididymitis

Incidence

From the analysis of the causative factors predisposing to the epididymitis, it is clear that the condition, in some cases, is transmitted sexually, in others instead, it is due to further factors, independently of the venereal transmission.

1. It is estimated that STDs are the most frequent causes of epididymitis among sexually active young people; risk factors include the lack of adequate sex education: some very sexually active but still inexperienced youths tend to change partners constantly and to consume relationships unwisely, without using condoms. It is clear that the aforementioned sexual behavior is at risk for the transmission of venereal diseases, and among these is also epididymitis.
2. Medical statistics show that the elderly and homosexuals represent the male categories most subject to epididymitis generated by bacterial infections of a non-sexual nature: in similar situations, the pathological condition is predisposed above all by surgical interventions (catheter or uroscopy) and by the enlargement of the prostate (urine stagnation in the bladder promotes bacterial infiltration). Even a missed circumcision, sometimes, could favor the epididymitis, since it greatly increases the probability of bacterial infections following an intimate hygiene that is not entirely appropriate.