Patient's question:
Can epididymitis be cured? What medicine is good to use? Which hospital is good in Sichuan?Doctor's answer:
Disease Analysis: Epididymitis is a common non-specific infection in the male reproductive system, often occurring in middle-aged and young adults. When the body's resistance is weakened due to various reasons, pathogens can take advantage of the opportunity to invade the epididymis, causing inflammation. It is characterized by sudden pain in the scrotal area, swelling of the epididymis, significant tenderness, and may be accompanied by fever, epididymal hardening, etc. Inflammation of the epididymis can affect sperm maturation, reducing its fertilization ability; it can also lead to blockage of the epididymal duct, impairing sperm output, all of which can cause clinical infertility.Treatment Suggestions:
1.1 General Management:
- Rest in bed.
- Using a scrotal support can alleviate symptoms. Homemade larger scrotal supports with cotton padding are more comfortable to use.
- Severe pain can be relieved with painkillers. Local heat therapy can ease symptoms and promote inflammation resolution. However, early use of heat therapy may worsen pain and risk spreading the infection, so local cold packs should be applied in the early stages.
- Sexual activity and physical labor can exacerbate the infection, so they should be avoided.
1.2 Use of Antibiotics:
- Select a drug sensitive to bacteria. Typically, intravenous medication is administered for 1-2 weeks, followed by oral antibiotics for 2-4 weeks to prevent the condition from becoming chronic.
1.3 Surgical Treatment:
- If antibiotic treatment is ineffective and testicular ischemia is suspected, epididymal incision and decompression should be performed. The epididymal visceral layer sac should be incised longitudinally or transversely, but care must be taken to avoid injuring the epididymal duct.
Treatment for Chronic Epididymitis:
- The effect of medication alone may not be ideal for chronic epididymitis. In addition to using effective broad-spectrum antibiotics, local heat therapy and other physical treatments are also necessary. Local application of emodin or neomycin via iontophoresis can also be considered.
- If chronic prostatitis is present, it must be treated concurrently.
- Epididymitis recurring due to chronic prostatitis may consider vas deferens ligation before treatment.
- For multiple recurrent episodes, epididymectomy may be considered.