1. What is tuberculous epididymitis?
Tuberculous epididymitis is a most common kind of tuberculosis of male genitourinary tract. Usually, it is accompanied with tuberculosis of prostate, tuberculosis of seminal vesicle, tuberculosis of kidney, retrograde infection of prostate and vas deferens, or partial hematogenous infection. Thus, it can clearly be seen that tuberculous epididymitis appears, in general, secondary to tuberculosis of prostate.
The key symptom of tuberculosis of epdidymis is manifested as the inflammation and swelling of epididymis that would form epididymal induration finally. Temporarily, the patients present no obvious signs, or sometimes have vague pain. When the swelling of epididymis becomes apparent, it might adhere to scrotum. In severe cases, it would discover that there is no clear boundary between testes and epididymis, and the vas deferens becomes thickening and presents as bead-like. If tuberculosis occurs in both sides of epididymis, it might induce azoospermia and infertility. Under the light microscope, it will discover deciduous epithelial cells in epididymal tubule, white blood cells and a large number of tubercle bacillus. Exactly, the tubercle bacillus is the pathogenic bacteria inducing tuberculosis of epididymis.
2. The symptoms of tuberculous epididymitis.
Usually, the tuberculosis of epididymis grows slowly and the epididymis become swelling gradually without overt pain. If a secondary infection emerges, it will cause redness, swell, heat and pain of testes. Meanwhile, the abscess becomes ulcerated and discharges mucus and withered necrotic materials. And then sinus is formed. Or it is manifested as high fever, serious pain and rapid enlarging of scrotum. In this case, it will cause induration, dermic adhesion and scrotal sinus that will be remained after the extinction of inflammation. The tuberculosis of epididymis is not accompanied with overt tendeness normally. In severe cases, there is no clear boundary between testes and epididymis, and the vas deferens becomes thickening and presents as bead-like, being with hydrocele of tunica vaginalis sometimes. In the digital examination of rectum, it will discover induration in the region of prostate. Finding the symptoms of epididymal induration, dermic adhesion, sinus and pathological change of vas deferens, it can be diagnosed with tuberculous epididymitis eventually.
3. The diagnosis for tuberculous epididymitis in traditional Chinese medicine.
According to the symptoms of the patients suffering from tuberculous epididymitis and the pathological changes by analysis of western medicine, traditional Chinese medicine diagnoses tuberculous epididymitis as stranguria caused by disorder of Qi.
As the chapter "The manifestations of Stranguria" of the book Treatiese on Causes and Manifestations of Diseases says, "Stranguria, is usually manifested as the dificiency of the kidney and heat in the urinary bladder, and caused by the distension of Qi." That is, due to damp-heat in lower-Jiao and the dysfunction of Qi of urinary bladder, it would finally induce the stagnancy of Qi and blood. If the stagnancy of Qi and blood appears the symptoms of redness and swelling, it is diagnosed with febrile disease, namely tuberculous infection with which it is diagnosed by laboratory examination of modern medicine. Through ultrasonic scanning, the pathological manifestations of stagnancy of Qi and blood include the swelling of epididymis, redness, swell, heat and pain of testes, thickening and being bead-like of vas deferens and emerging sinus, etc.
4. The treatments for tuberculous epididymitis in traditional Chinese medicine.
Usually, in the process of curing tuberculous epididymitis, traditional Chinese medicine employs the clearing-away-heat-and-toxic material type of drugs to eliminate tubercle bacillus, and it is recommended to use with the promoting-blood-circulation-and-activating-Qi type of drugs and softening-hard-lumps-and-dispelling-nodes type of drugs to cure the swelling and redness of epididymis, which will take effect in 3 to 4 months both.
Key words: epididymitis; tuberculous epididymitis; epididymitis diagnosis; epididymitis treatment
