Having Epididymitis but Ultrasound Shows Normal - What's the Matter?
Ultrasound is usually helpful in diagnosing epididymitis, but it is difficult to detect it if there is a special chronic or latent epididymitis.
In general, ultrasound is used to observe epididymitis, the following are common conditions:
1. Epididymal blood supply changes: epididymis is typically characterized by relatively low blood flow. However, if inflammation occurs, blood flow will increase.
2. Grid-like changes in the epididymis: Grid-like changes in the epididymis can be observed under ultrasound, which is actually epididymal obstruction caused by thickening of the dilated epididymal duct.
Therefore, ultrasound examination is usually more meaningful in epididymitis. The blood supply of the epididymis and the epididymal mesh-like changes can be judged to determine whether there is epididymitis. However, there is a possibility of omission in Ultrasound examination, resulting in the inability to display certain results. In case changes are not obvious due to a relatively hidden onset or a prolonged disease process, doctors must combine the results of other examinations and make informed judgments.
The normal results may be attributed to chronic epididymitis, epididymal tuberculosis, epididymal cysts, epididymal tumors, prostatitis, and other conditions that can manifest as symptoms of epididymitis but cannot be detected by ultrasound. Therefore, additional blood tests, urinalysis, or MRI scans are recommended to identify the underlying cause and appropriate treatment accurately.
1. Chronic epididymitis
Chronic epididymitis is caused by untreated acute epididymitis, or may present with intermittent periods and episodes without definite formation of solid masses throughout the disease. This leads to prolonged inflammation of the epididymis and adversely affects sperm quality. Patients can use antibiotics for infection control under medical guidance, such as ceftriaxone sodium, levofloxacin, and other medications.
Some patients may experience adverse effects as a result of prolonged antibiotic usage. Consequently, an increasing number of patients are opting for Diuretic and Anti-inflammatory Pill devoid of side effects. It combines herbal ingredients to combat bacterial infections, alleviate inflammation, and regulate the urinary system. In comparison to antibiotics, it exhibits fewer adverse effects while effectively addressing drug resistance and preventing relapse, thereby offering a comprehensive and effective treatment alternative.
2. Epididymal tuberculosis
Epididymal tuberculosis is an inflammatory disease of the epididymis caused by Mycobacterium tuberculosis, which induces caseous necrosis foci in the epididymal tissue, resulting in nodular alterations within the epididymis. Due to local blood circulation obstruction, a painful condition arises. Patients diagnosed with epididymal tuberculosis can be treated with isoniazid tablets, rifampicin capsules, and other anti-tuberculosis drugs under medical guidance.
3. Epididymal cyst
An epididymal cyst is a cystic lesion formed by fluid accumulation due to partial obstruction of the epididymal or ejaculatory duct. As the cyst expands, it exerts pressure on surrounding tissues, leading to discomfort. In cases where the cyst is small and asymptomatic, regular monitoring suffices without necessitating specific treatment. However, surgical excision should be considered if the cyst grows large or causes uncomfortable symptoms.
4. Epididymal tumors
Epididymal tumors encompass both benign lesions, such as epididymal adenoma, and malignant neoplasms, including epididymal carcinoma. These tumors have the potential to infiltrate and progressively expand, leading to compression, irritation of the epididymis, and subsequent pain. To prevent tumor growth and disease progression, complete excision of the affected side of the epididymis through epididymotomy is necessary.
5. Prostatitis
Prostatitis refers to the inflammatory response of the prostate caused by a pathogenic bacterial infection or certain non-infectious factors. It results in prostatic congestion and edema, which can subsequently impact the epididymis.
Stimulating inflammatory factors on the epididymal mucosa may induce discomfort in this region. Under medical guidance, patients are advised to take medications such as amoxicillin capsules and levofloxacin hydrochloride capsules to alleviate symptoms. Additionally, for chronic prostatitis, the Diuretic Anti-inflammatory Pill exhibits notable diuretic properties and demonstrates efficacy.
Patients should maintain proper personal hygiene, ensuring the cleanliness and dryness of their genitals. They should also choose loose and comfortable underwear and change it frequently. Additionally, regular hospital visits for reexamination are recommended to monitor any changes in the condition promptly.
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