Epididymitis (inflammation of the epididymis ) is often detected in men between the ages of twenty and fifty. The causative agents of the disease are trichomonads and gonococci.
There are many factors that contribute to the development of pathology. Among the most common, hypothermia, scrotal injury, horseback riding, physical strain, endoscopic examinations, and interrupted intercourse should be highlighted . As a rule, a disease affects one testicle. In rare cases, bilateral epididymitis is detected.
Treatment of the pathology is selected in accordance with the symptoms and nature of its course. In the chronic form, therapy is aimed at eliminating the cause of the disease.
Acute epididymitis
As a rule, a disease in this form begins to develop rapidly, accompanied by an increase in temperature, a sharp increase in size and compaction of the epididymis, intense pain, as well as swelling and redness of the scrotum. The testicles and the vas deferens can be involved in the inflammatory process.
In the presence of timely and appropriate treatment of symptoms, acute manifestations subside over the course of a week. However, compaction and an increase in the appendage may remain for a long period.
Treatment of epididymitis in this form involves the use of pain-relieving drugs. As a rule, the patient is recommended rest and bed rest. It is absolutely necessary to fix the scrotum with a bandage or use a suspension (supporting bag).
The doctor prescribes antibiotics that affect the pathogens that provoked epididymitis. In this case, treatment should be long, since the complete elimination of all symptoms can occur after several weeks, and in some cases, even months after the start of therapy.
When choosing antibiotics, the patient's sexual status and age are taken into account. So, for patients younger than thirty-five years of age with concomitant urethritis and a sexually transmitted infection, it is advisable to prescribe drugs of the tetracycline group (Doxycycline), individual fluoroquinolones (Levofloxacin, Ofloxacin), macrolides (Roxithromycin, Azithromycin and others )
For patients over the age of 35, whose urinalysis revealed the presence of bacteria, there are signs of damage or abnormalities of the urinary tract or endourethral studies have been performed against the background of moderately intense symptoms accompanying epididymitis, treatment may include taking Co-trimoxazole.
The adjustment of the choice of antibiotic depends on the results of studies of the sensitivity of microflora.
For the period of therapy, sex, spicy dishes, alcohol, hypothermia are excluded.
With the transition of the acute form of the disease to chronic epididymitis, treatment continues with antibiotics. In addition, absorbable therapy is necessary. It includes injections of aloe, "Lidase", the vitreous. Injections are administered subcutaneously for twenty to thirty days. Another therapeutic measure is iontophoresis with hydrocortisone (“Lidase”) on the area of the patient's appendage.
The use of antibiotics should be combined with drugs of general effect (immunostimulants, antihistamines). Some cases suggest a single method of treatment - surgical. At the same time, surgical removal of the epididymis prevents the development of complications of epididymitis, including infertility.
Physiotherapeutic treatment is also important in the process of eliminating pathology. As the main procedures, ultrasound, phonophoresis is prescribed. Herbal compresses can also be effective.