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Acute Orchiepididymtis

  • A quarter of men in their middle-ages are suffering from this pathology

    Orchiepididymitis is the inflammation of the epididymis (acute epididymitis) and the testicle (acute orchiepididymitis). It can result from a complication due to a bladder infection, from non-specific urethritis, gonorrhea, prostate surgery or a catheterization method in the urinary bladder. What happens is an augmentation of the testicles volume which increases pain and the testicles temperature, something that is noticeable at touch. Generally, there is more liquid in the scrotum and the person can also have a fever. In certain cases abscess (collection of pus) appears, abscess that is identifiable at touch as a soft volume in the scrotum. This abscess can drain itself naturally but in certain cases we have to do it chirurgically.

    Inflammation in the epididymis (acute epididymitis), which is also associated with inflammation in the testicle (acute orchiepididymtis) is one of the most frequent urologic diseases. More than 25% of young men and in their middle-ages are suffering from this disease.

    Numerous studies show us the existence of various ways through which infection penetrates the epididymis. The most part of researchers point towards three major channels of infection: hematogenic, lymphogenic and intracanalicular. A.L. Shabad (1990) underlines the importance of the intracanalicular tract (adhesion reflexive mechanism). 18% of acute orchiepididymtis cases result from post-operatory complications. Severe and even lethal complications of acute epididymitis can occur, including bacteriologic shock and urosepsis.

    The evolution of acute orchiepididymtis towards a chronic stage brings consequences that are particularly severe: the obstruction of the epididymis and the development of sclerotic and dystrophic testicular processes will end up causing reproductive dysfunctions and infertility.
    In current medicine the treatment of various pathologies with low level laser therapy has achieved major interest and importance, due to the fact that lasertherapy produces anti-inflammatory and analgesic effects, increasing general and local immunity. Furthermore it improves microcirculation in the area of inflammation by producing an effect in the permeability of vascular walls. The photoactive effect of biologic and physiologic processes in the organism after a local treatment, is one of the fundamental characteristics of laser therapy.
    The correct definition of the type of disease is essential to create a differentiated treatment.
    M.L. Mufaged (1995) proposed a four stage classification according to clinical/laboratorial/echographic alterations at the epididymis and the patient´s testicles with acute epididymitis and acute orchiepididymtis:

    • Serous;
    • Purulent/infiltrative;
    • Purulent/microfocal destructive;
    • Purulent/macrofocal destrutive (abscess).

    It has been defined that the stage of acute epididymitis and acute orchiepididymtis is correspondent with the time length of the disease. Has so, when the patient doesn’t receive proper treatment and the disease lasts for 3 days the 1st stage of acute epididymitis is developed, but if this pathology lasts for 5 days then the 2nd stage starts. If the length is more than 5 days we get into the 3rd stage and at last, if it goes for more than 7 days we reach the 4th stage.
    The treatment of acute epididymitis depends on the type and virulence of the disease´s causing agent but also on the general state of the patient´s immune system.

    Diagnostic methods for acute epididymitis, acute orchiepididymtis and the control methods for the efficacy of magneto-laser therapy, are all divided in 3 major groups; clinical methods, laboratorial methods and ultrasonic methods.

    Monitoring things through the ultra-sound allows us to, during the treatment, correct and optimize the dosages as well as the magneto-laser therapy parameters [M.L. Mufaged, 1995].
    The control of this therapy´s efficacy is done by ultra-sound monitoring in a three days interval, starting from the beginning of therapy.
    Since acute epididymitis is found in 25% of men towards their middle-age (and in many cases it´s associated with acute orchiepididymtis), it is urgent to entail efficient measures of treatment. In these cases, the low level therapy laser is the right answer.