Patient's question:
Testicular swelling and severe pain, which can be relieved when lying down but worsen with walking. How should orchitis be diagnosed?Doctor's answer:
Early epididymitis is a cellulitis that starts in the vas deferens and spreads to the tail of the epididymis. During the acute phase, the epididymis becomes swollen and hard, and the infection spreads from the tail to the head of the epididymis. On pathological sections, small abscesses can be seen, and the tunica vaginalis often exudes serous fluid. This fluid may contain pus, the spermatic cord may become thickened, and the testis may develop secondary congestion and edema. However, it generally does not recur. Under the light microscope, tissue edema, neutrophils, plasma cells, and lymphocytes can be observed infiltrating the area, followed by the formation of abscesses. The epithelium shows pyknosis, and the inflammation can be completely resolved. However, fibrosis around the epididymal tubules often leads to lumen obstruction. If bilateral epididymitis occurs, it may result in infertility.