Causes of testis abscess, diagnosis and treatment

Testicle abscess - urological pathology, purulent complication of inflammation in the testicle( orchitis).The disease is a capsular focus in the tissues of the male sexual gland. It is rare, with the timely treatment of a man with a diagnosis of orchitis to a urologist and properly selected therapy, as a rule, does not reach purulent complications.

Causes

isolated disease practically does not occur. The provoking factors include:

• 

  Inflammatory diseases of the male genital area - the main cause of testicle abscess.

  inflammatory diseases of the male sexual sphere( prostatitis, prostatocystitis, epididymitis, orchitis, vesiculitis, urethritis);

• sexually transmitted diseases in history;
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• operative interventions on the organs of the male sexual sphere;
• generalized infections that occur against the background of oppression of the immune system( for example, ARVI against the background of HIV infection);
• marked concomitant pathology( diabetes mellitus in the stage of decompensation, obesity, immunopathies of different genesis);
• Drug use, chronic alcoholism, antisocial lifestyle;
• trauma of scrotum organs;
• advanced testicular tumor;
• tuberculosis of the testis and epididymis;
• scrotal skin abscess;
• subcooling.

Symptoms of the abscess of the testicle

Because the disease is purulent-inflammatory, it is characterized by all the classic signs of inflammation:

• 

  Severe pain and scrotal enlargement indicate an inflammatory process.

  Expressed, intense pain in the corresponding half of the scrotum, an increase in its size, mainly on the side of pathology. In a bilateral process, the scrotum may increase 1.5-2 times evenly;

• Hyperemia of the scrotum skin;
• General inflammatory intoxication of the body( weakness, headache, sweating, osteoarticular pain);
• Temperature rise to febrile( 39-40 ° C);
• Dysfunction of the affected organ.

In addition, the clinic of the underlying disease can appear:

1. Acute inflammatory process in the prostate( and in the bladder) will manifest itself pains in the lower abdomen, perineum, dysuric disorders( rezi with frequent urination, sensation of incomplete emptying of the bladder);
2. In vesicles, the appearance of a blood impurity in the semen is typical;
3. Urethritis is characterized by pain, rezi in the urethra with the act of urination and after, excretion. Depending on the microbial flora can be from transparent to yellowish purulent;
4. With a tumor, the picture is similar to orchitis, pay attention to the history data, in the decay, the necrotic tissues are visualized with a purulent-purulent discharge, with an unpleasant odor;
5. Clinic of tuberculosis of the testicle is similar to the clinic of orchitis, when collecting anamnesis pay attention to the recurrent nature of the disease;
6. The abscess of the skin of the scrotum is manifested by changes in the skin of the scrotum, by coagulation. With an independent breakthrough, purulent-bloody discharge is visible. Whether the process has spread further to the testicle will be clear after ultrasound diagnosis.

Diagnosis

The diagnosis does not present a significant complexity. As a rule, the preliminary diagnosis is clear after a preliminary examination.

Differential diagnosis is carried out with orchitis( inflammation of the testicle), festering scrotum atheroma triggered by a testicular tumor, testicular tuberculosis. Palpation of the scrotum organs is considerably hampered by the severity of the pain syndrome and general edema.

Laboratory tests

• 

  For diagnosis, ultrasound of the pelvic organs is performed.

  general blood test, general urine analysis;

• blood for hepatitis B and C, HIV infection, syphilis by ELISA;
• smear from the urethra on sexually transmitted infections( gonorrhea, chlamydia, trichomoniasis and others);
• bacterial culture on the establishment of an agent and sensitivity to antibacterial therapy;
• PCR - diagnosis of tuberculosis to exclude a specific process;
• is the secret of the prostate.

Instrumental diagnostics

To clarify the diagnosis, ultrasound of the pelvic organs( scrotum, prostate, bladder) is performed.

If suspicion of the spread of the pathological process is shown by magnetic resonance imaging, which will help to clarify the localization of the initial focus and pathways of infection.

Treatment

Surgical treatment

Treatment of an abscess of the testis is operative, it is based on the principles of general purulent surgery.

Young patients, if possible, perform an autopsy and drainage of a purulent focus, age-related men are more likely to receive an operative aid in the form of orchiectomy( removal of the affected testicle), since the risk of spreading the pathological process is too high.

Medical treatment

1. 

   The medical treatment of an abscess of the testicle consists mainly in the administration of antibiotics.

   Antibacterial drugs for abscess of testis. An antibacterial preparation with a broad spectrum of action is prescribed. After a while, with a weak positive dynamics, a second antibiotic is included in the scheme, taking into account the results of seeding on the sensitivity to antibacterial therapy. In the first day after surgical treatment for an abscess of the testicle, the intravenous route of administration of an antibacterial preparation is preferable.

2. Non-steroidal anti-inflammatory drugs. In addition to providing an anti-inflammatory effect, it will help reduce pain syndrome and normalize the temperature response.
3. Probiotics. Normalize the intestinal flora, prevent the development of candidiasis of the intestine.
4. Antifungal means. Reduce the risk of developing urogenital candidiasis( thrush).
5. Multivitamin Complexes and Immunomodulators. Improve the work of the immune system and stimulate the development of local immunity. Detoxification products. At the expressed general intoxication detoxication therapy is spent.

Possible consequences and prophylaxis

In organo-carrying out operation it is possible to change the hormonal background of a man, but, as a rule, the function of producing male sex hormones takes on the remaining testicle.

If there was a history of the disease remaining the only testicle, the development of secondary infertility is possible.

In the case of an organ-saving operation( opening and draining an abscess), the process can be chronically.

The prognosis for life with a nonspecific abscess of the testicle or epididymis is favorable. At specific( a tumor, a tuberculosis) in each case it is considered individually.

The use of condoms for casual sexual intercourse, regular passage of urological examination, careful attitude to men's health will help to never encounter this serious urological pathology.

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