Treatment for Epididymitis

In addition to the general symptomatic treatment of relieving pain, swelling and other symptoms, the treatment of acute epididymitis mainly includes the rational use of antibiotics and surgical treatment.

 

The purpose of treatment is not only to improve the symptoms and signs of the patients themselves, but also to avoid the delay, the development of chronic epididymitis, the transmission of potential chlamydia, gonorrhea and other infections to other people, as well as the prevention of complications.
 

Acute epididymitis
 

In the treatment of acute epididymitis and acute attack of chronic epididymitis, antibiotics are mainly used, and surgery is feasible when necessary.
 

The patients with acute epididymitis have obvious pain. In order to relieve the discomfort, they can take nonsteroidal anti-inflammatory drugs and other analgesic drugs, or use 1% lidocaine as spermatic cord block to relieve the pain.
 

General treatment
 

Patients should rest in bed or brake to ensure reasonable nutrition and raise scrotum.
 

In the early stage of the disease, local ice compress, later hot compress or hot water sitting bath. It should be noted that this may temporarily affect the spermatogenic function of testis. Therefore, those who have not yet given birth should use it with caution.
 

Local wet compress with 50% magnesium sulfate solution can reduce the swelling of scrotal skin and epididymis, and promote the dissipation of inflammation.
 

If the condition allows, the catheter should be removed as soon as possible; if the condition does not allow, suprapubic cystostomy can be used to transfer urine.
 

Medication

 

1. Antimicrobial application
 

Acute epididymitis:
 

It is necessary to select bacteria sensitive drugs, usually intravenously, for 1-2 weeks; in order to prevent inflammation from turning chronic, it is necessary to continue to take antibiotics orally for 2-4 weeks. The commonly used drugs include cephalosporins, quinolones, macrolides, etc.
 

Epididymitis caused by sexually transmitted infection is usually treated with cephalosporins, doxycycline and levofloxacin.
 

Ofloxacin or levofloxacin is the first choice for epididymitis caused by Enterobacteriaceae.
 

Chronic epididymitis:
:
In the treatment of chronic epididymitis, antibiotics alone may not be able to achieve the desired effect, but berberine and other drugs can be used in epididymis for iontophoresis.
 

When combined with acute attack, antibiotics can be given. Generally, the drug should be used according to the experience, after the results of bacterial culture and drug sensitivity test come out, the targeted antibiotic treatment should be selected, and the course of treatment is generally 2 weeks.

 

If patients with chronic prostatitis at the same time, must be treated at the same time, to avoid repeated attacks due to incomplete treatment of the source of infection.

 

2. Surgical treatment
 

Acute epididymitis:
 

When the effect of antibacterials is not ideal, or when testicular ischemia is suspected, epididymal incision and decompression should be carried out, and the epididymal canal should be avoided as much as possible during the operation. If the adjacent fascia of spermatic cord at the same time, the effect of improving testicular blood circulation will be better.
 

If the inflammatory mass of epididymis is enlarged and wave motion appears, it indicates that abscess is formed, and should be cut and drained in time. When testicular infarction occurs, the testis should be resected.
 

Chronic epididymitis:
 

If the treatment of chronic prostatitis is not timely to cause repeated epididymitis, the vas deferens can be ligated before further treatment. For epididymitis with repeated attacks, if the effect of other treatment methods is not ideal, especially when the antituberculous treatment of tuberculous epididymitis is ineffective, epididymidectomy can be considered.
 

TCM treatment
 

Traditional Chinese medicine treatment can improve microcirculation, reduce the formation of epididymal fibrous tissue, shorten the course of disease without side effects, such as the common herbal medicine Diuretic and Anti-inflammatory Pill.
 

Frontier treatment
 

At present, there is no definite frontier treatment method and drug for clinical application.

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