Patient's question:
Can varicocele scrotal hardening go away? Will persistent hardening affect fertility?Doctor's answer:
Epididymitis only leaves epididymal nodules (which are the proliferation of fibrous tissue and scar tissue) if it is not completely cured. Epididymitis, like other diseases, is divided into acute and chronic types, with different causes for each. During acute epididymitis, the epididymis becomes swollen and hardened, and the infection usually spreads from the lower pole to the upper pole of the epididymis. Epididymitis is often caused by the spread of infection from nearby organs. It is characterized by sudden pain in the scrotum, swelling of the epididymis, significant tenderness upon touch, and may be accompanied by fever, epididymal hardening, etc. Epididymitis is often secondary to infections of the urethra, prostate, or seminal vesicles. Chronic epididymitis is usually caused by incomplete treatment during the acute phase, and at this stage, it may frequently present with symptoms less severe than acute epididymitis. Due to fibrosis, the entire epididymis hardens in chronic epididymitis, which may cause scrotal pain, a heavy or distended sensation, and pain that radiates to the lower abdomen and the inner side of the same thigh. The epididymis may be mildly swollen, hardened, and nodular, with mild local tenderness, and the ureter on the same side may become thickened. Chronic epididymitis can often flare up acutely. A unilateral epididymal head nodule generally does not significantly affect fertility, but if it is bilateral, especially if it is a nodule at the tail of the epididymis, it may block the spermatic ducts and hinder sperm maturation, thereby affecting fertility and causing infertility. Once a nodule at the tail of the epididymis forms, the only way to remove it is through surgery, as scar tissue does not contain sperm and can lead to azoospermia. If acute epididymitis is suspected along with chronic prostatitis, it is important to focus on the treatment of complications, such as (prostatitis), and undergo relevant tests for confirmation if necessary, such as digital rectal examination, routine prostatic fluid analysis, and transrectal ultrasound of the prostate.