Acute Epididymo-orchitis Research Articles

Acute Bacterial Epididymo-Orchitis Caused by Mycobacterium tuberculosis

Acute Bacterial Epididymo-Orchitis Caused by <i>Mycobacterium tuberculosis</i>

The role of scrotal ultrasonography from infancy to puberty.

BackgroundScrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new‐generation ultrasound machines characterized by clearly improved image quality, low health cost, and higher patient safety, represents only some characteristics of ultrasound investigation. The usefulness of scrotal ultrasonography is particularly evident in the period of life from infancy to puberty, during which males undergo important morphofunctional changes, and several pathological conditions may occur.ObjectivesThis pictorial review primarily aimed to investigate the aspects of ultrasonography related to the normal physiological development of the gonads from mini‐puberty to pubertal onset. This study also aimed to provide an update on the use of ultrasonography in main andrological pathologies that may occur during this period. The conditions that are discussed in depth are: cryptorchidism, inguinoscrotal hernias, and hydrocele in the neonatal phase; acute scrotum, epididymo‐orchitis, and testicular cancers in childhood; and hypogonadism, varicoceles, testicular microlithiasis, and oncohematological pathology in puberty.DiscussionWe provided an ultrasound slant for all the above‐mentioned pathologies while purposely avoiding excessive deepening of the pathogenetic, clinical, and therapeutic aspects. Studying the ultrasound aspects of the gonads also facilitates differential diagnosis between various conditions and represents a good aid in evaluating therapeutic success (e.g., in hypogonadism or postsurgical evaluation of varicoceles and cryptorchidism).ConclusionScrotal ultrasonography is now globally recognized as the necessary completion of clinical–laboratory overview in gonads evaluation. This diagnostic procedure is even more indispensable in the infancy–childhood–puberty period for the evaluation of normal gonadal development as well as diagnosis of other possible diseases.

SARS-CoV-2 infection affects the lower urinary tract and male genital system: A systematic review.

PubMed, Scopus, and ISI Web of Knowledge databases were searched to identify studies published up to December 2020 on the involvement of urinary and male genital systems in COVID‐19. Sixteen studies involving a total of 575 patients (538 males and 37 females) were included in this systematic review. The COVID‐19 phase was available for 479 patients: 426 in the acute and 53 in the recovery phase. De novo lower urinary tract symptoms (LUTS) were observed in 43 patients and deterioration of pre‐existing LUTS in 7. Bladder hemorrhage was observed in three patients and acute urinary retention in one. Regarding the male genital system, scrotal discomfort was observed in 8 patients, swelling in 14, pain in 16, and erythema in 1; low flow priapism was observed in 2 patients. Ultrasound examination identified acute orchitis in 10 patients, acute epididymitis in 7, and acute epididymo‐orchitis in 16. A case–control study reported that patients with moderate COVID‐19 show a significant reduction in sperm concertation, the total number of sperms per ejaculate, progressive motility, and complete motility. In contrast to what is known from the first studies on the subject, this review also includes subsequent studies that give evidence of the involvement of the lower urinary tract and male genital system in COVID‐19.

Гольмиевая лазерная энуклеация предстательной железы – новый «золотой стандарт» хирургического лечения ДГПЖ в г. Москве

Introduction. Benign hyperplasia of prostate (BPH) is still one of the most common urological diseases of elderly and senile age. Transurethral resection of prostate (TURP) is considered as a gold standard of BPH surgical treatment. However, TURP is recommended for prostates with volume up to 80 cm3 . In this connection new minimally invasive methods are being searched permanently to improve the results of surgical treatment of patients with prostate volume exceeding 80 cm3 . Materials and methods. The results of 150 cases of HoLEP performed by a single surgeon in the period from June 2018 till December 2019 are analyzed. Average age 67,8 (±7,7) years. Preoperative examination besides general clinical tests, IPSS, TRUS of prostate, uroflowmetry, US-measure of postvoiding residual volume (PVR), PSA testing. The median of prostate volume was 74 (29-272) сm3 , 94 (62%) patients were able to urinate with average Qmax of 7 (2-25) ml/sec, average IPSS score was 21.6 ± 4.4, chronic urinary retention (PVR &gt; 100 ml) was diagnosed in 44 (29%) patients. 56 (38%) patients had suprapubic catheter. Hemoglobin before surgery 142.6 ± 12.3 g/l. Surgery was performed with holmium laser Lumenis Pulse 100H. Postoperative control tests were performed before discharge of patients from the hospital. Results. The median of surgery time was 90 (30 – 180) min. The mean estimated blood loss was 133,4 ± 14,3 g/l. We drained bladders with urethral catheters for 3.0 (1-5) days in average. Average Qmax was 22,9 ± 8,6 ml/sec and PVR was 55,0 ± 8,0 ml. Average hospital stay was 5,0 (2-15) days. Intra- and postoperative complications were: perforation of bladder wall in 4,6% cases, perforation of prostate capsule in 7.3% patients, residual tissue in the bladder after morcellation in 2,6% cases, clot retention in 5,3% cases, 1,3% patients needed blood transfusion, acute urinary retention after urethral catheter removal was in 8.6% cases, acute bacterial prostatitis in 3.3% patients, acute urethritis in 2.6% cases, acute epididymo-orchitis in 4% cases, stress urinary incontinence in 14% patients. Discussion. At present, the search for new techniques to improve the quality of surgical treatment of BPH, including with a large pancreatic volume, is not stopped. The developed «laser technologies» are aimed at reducing the risk of complications and improving the quality of life of patients in the postoperative period. The results of numerous studies and our results carried out indicate the high clinical efficiency of the holmium laser, the possibility of its application for large and gigantic pancreatic sizes. It should be noted that the safety level of HoLEP is higher, the period of bladder catheterization is shorter, the patient's stay in the hospital and financial costs are less, and the quality of life after surgery is higher. The results obtained are comparable with the data of the international literature and indicate the high efficiency and relative safety of HoLEP. Conclusion. The obtained results indicate the high efficiency and relative safety of HoLEP in the surgical treatment of BPH, regardless of its volume. The results obtained allow us to assert that there is a new «gold standard» for surgical treatment of BPH and consider the possibility of introducing HoLEP into the standards of medical care for urological patients with BPH.

Ultrasound Imaging Findings of Acute Testicular Infection in Patients With Coronavirus Disease 2019: A Single-Center-Based Study in Wuhan, China.

Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, raising widespread public health concerns. Our team treated hospitalized patients with COVID-19 in Wuhan, where the outbreak first began, and we suspected that SARS-CoV-2 may cause testicular infection in male patients. We conducted this study to explore that observation. We enrolled male patients with a confirmed diagnosis of COVID-19 and performed a bedside ultrasound (US) examination of the scrotum, focused on findings of acute inflammation such as tunica albuginea thickening, enlargement and heterogeneous echogenicity of the testis, epididymis, or both, an abscess, scrotal wall edema, and hydrocele. Then we compared the proportions of observed epididymo-orchitis in patients from different age groups and COVID-19 severity groups. A total of 142 patients with COVID-19 were enrolled in our study, and 32 (22.5%) patients had acute orchitis, epididymitis, or epididymo-orchitis on scrotal US imaging, according to the diagnosis criteria. The observed risk of acute scrotal infection increased with age, with the incidence reaching 53.3% in men older than 80 years. We also observed that men with severe COVID-19 had a significantly higher possibility of epididymo-orchitis compared to the nonsevere COVID-19 group (P = .037). This study shows US imaging evidence that SARS-CoV-2 may cause infection of the testis or epididymis, and the risk is worthy of the attention of clinicians.

PT249 - Outcome of acute epididymo-orchitis: Risk factors for testicular loss

PT249 - Outcome of acute epididymo-orchitis: Risk factors for testicular loss

Rickettsial epididymo-orchitis – An emerging threat in endemic areas

Introduction: Rickettsial infections are reemerging infections in various parts of the world. Although there can be protean manifestations of rickettsial infection, epididymo-orchitis is by far uncommon. Materials and Methods: Fifty patients with a mean age of 35.1 (17–67) years with signs and symptoms suggestive of acute epididymo-orchitis were evaluated and 15 of these positive for Weil–Felix Reaction were included in the study after ruling out the common causes of epididymo-orchitis. Results: Fifteen patients had positive Weil–Felix reaction and were considered to have rickettsial epididymo-orchitis. Seven patients had right, 5 had left, while 3 had bilateral epididymo-orchitis. Most of the patients presented within 2 weeks of onset of symptoms. Five patients were positive for OX2, four patients were positive for OXK titers, four for OX19 and OX2, while two were positive for OX19 Weil–Felix reaction. These patients were started on doxycycline 100 mg bd for 7 days and followed up. In the follow-up, none of them developed complications of testicular abscess or chronic epididymo-orchitis. Conclusion: Rickettsial epididymo-orchitis is a very rare entity and it as an emerging threat in endemic areas. We strongly recommend that in the areas endemic for Rickettsia, all cases of epidiymo-orchitis should be evaluated for the presence of rickettsial infection, as early identification of such an infection would lead to prompt and precise management.

A study on clinical presentation scrotal swellings at a tertiary care hospital

Sometimes scrotum can become swollen without any apparent cause. This condition, known as idiopathic scrotal edema, is thought to be caused by streptococcus hemolyticus and Cl. Welchii. Scrotum can become swollen due to systemic illnesses causing generalized edema, as in congestive cardiac failure (CCF), nephritic syndrome, and cirrhosis of liver and hypoproteinaemic states. The 100 cases admitted to the surgical wards in Medical College Hospital and Research Center, formed the material for this study. Various types of hydrocele formed the majority of the cases (50) in this study, out of which primary vaginal hydrocele (45%) was the commonest followed by varicocele (13%). Epididymo-orchitis accounted for 9% of the cases out of which 7 were acute epididymo-orchitis due to UTI (E. coli, Proteus, Klebsiella). Chronic epididymo-orchitis due to tuberculosis was seen in two.

Acute epididymo-orchitis: relevance of local classification and partner's follow-up.

IntroductionAcute epididymo-orchitis (AEO) is a male urological emergency without an approved clinical classification. We aimed to determine the clinical value of proposed in 2012 local AEO classification system and summarize results of partner's follow-up.Material and methodsA total of 293 patients with AEO were enrolled into our study. Based on the investigated AEO classification, they were divided into four groups: 118 patients (40.3%) with Stage I AEO; 97 patients (33.1%) with Stage II AEO; 42 patients (14.3%) with Stage IIIA AEO; 36 patients (12.3%) with Stage IIIB AEO.If after 72 hours of conservative treatment there was no clinical improvement, AEO patients underwent surgery. We analyzed the clinical value of the investigated classification system and results of partner's follow-up.ResultsOnly 3 (2.5%) patients with Stage I AEO required surgery. In patients with Stage II AEO, conservative treatment was effective in 79 (81.4%) cases. A total of 27 (64.3%) patients with Stage IIIA and 36 (100%) patients with stage IIIB AEO underwent surgery. Sexually transmitted infections (STIs) were detected in 176 (60.1%) cases among 293 patients with AEO and bacterial infection in 117 (39.9%) cases. We registered a statistically lower incidence rate of trichomoniasis in AEO patients compared to their sole female partners (13.8% vs. 23.3%, p <0.05). Distribution of other STIs in AEO patients and their sole partners was similar.ConclusionsThe investigated classification system enables the determination of a treatment strategy in patients with AEO. Partner's follow-up allows for the clarification of the etiology of disease, complete evaluation of STIs and prevents reinfection in couples.

Dynamics of еndothelin-1 level and the development of complications in patients with acute epididymoorchitis

In this study attempted to clarify the diagnostic and prognostic significance of changes in the content of endothelin-1 (ET-1) in plasma of patients with acute epididymoorchitis in connection with blood circulation in the testis of the appendage. To determine the concentration of ET-1 using ELISA method. In all examined patients before treatment revealed a significant increase in the concentration of ET-1. In the preoperative period, 43% of patients with irreversible complications (lack of blood flow to the testicle or appendage, the CDC-signal) concentration of ET-1 to the 7th day remained high (25,8±3,2 ng/ml, exceeding the norm by 2,5 times), which indicates the irreversible microcirculatory disorders in testicle (appendage), possibly by increasing vasoconstriction of blood vessels. In 57% of patients were observed for complications, processes are reversible ischemia, and the concentration of ET-1 gradually decreased until the 14th day amounted to 5,8±0,6 ng/ml, returning to the range of normal. Changes in the concentration of ET-1 in blood plasma indicates the reversibility of metabolic disorders related testicular tissue ischemia, as well as diagnostic and prognostic significance of this factor determining the relative risk of complications.

MP15-07 EMPIRIC ANTIBIOTIC THERAPY FOR ACUTE EDIDIDYMO-ORCHITIS IN YOUNG MEN – DOES ‘ONE SIZE’ FIT ALL?

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia I1 Apr 2018MP15-07 EMPIRIC ANTIBIOTIC THERAPY FOR ACUTE EDIDIDYMO-ORCHITIS IN YOUNG MEN – DOES ‘ONE SIZE’ FIT ALL? Arnon Lavi, Sharon Tzemah, Genady Zelichenko, Anan Hussein, Ibrahim Bishara, Michael Gross, and Michael Cohen Arnon LaviArnon Lavi More articles by this author , Sharon TzemahSharon Tzemah More articles by this author , Genady ZelichenkoGenady Zelichenko More articles by this author , Anan HusseinAnan Hussein More articles by this author , Ibrahim BisharaIbrahim Bishara More articles by this author , Michael GrossMichael Gross More articles by this author , and Michael CohenMichael Cohen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.520AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Acute epididymo-orchitis (AEO) is common. The common infectious etiology in men younger than 35 are Chlamydia Trachomatis & Neisseria Gonorrhoeae. In men older than 35 gram negative bacteria are the common etiology. Empiric antimicrobial treatment are issued accordingly. It was reported that idiopathic AEO is responsible for 90% and 54% of pediatric and adult AEO cases, respectively. With growing bacterial resistance, cautious antimicrobial use is crucial. Identifying patients with non-infectious/idiopathic AEO can reduce unnecessary antimicrobial use. We set to characterize AEO etiology and define predictors for an infectious etiology in order to reduce unnecessary empiric antimicrobial use. METHODS We reviewed medical records of young patients (age 18-50) presenting at our institution with AEO during a 4 year period. We assessed clinical parameters on initial patient presentation and performed a uni and multivariate analysis to asses predictors for an infectious etiology on the microbiology assays (urine culture and urine polymerase chain reaction assay for sexually transmitted disease (STD)). RESULTS We identified 167 patients. Only 49% were found to have an infectious etiology with 34% enterobacteria, 17% sexually transmitted organisms and 4% of brucelleosis AEO. In 51% microbiology assays were negative. Clinical predictors for an infectious etiology on univariate analysis are presented in table 1. On multivariate analysis fever, positive urine dipstick and nitrates in particular, were predictors of an infectious etiology (p=0.03; p=0.04; p=0.01) CONCLUSIONS Infectious etiology for AEO was found in only half of the patients. On multivariate analysis predictors for an infectious etiology were fever, positive urine findings on urine dipstick and especially positive nitrates on initial presentation. It appears reasonable to consider deferring antimicrobial treatment in patients with no fever and a negative urine dipstick until final microbiology results are obtained. Close follow-up is necessary in these patients. Randomized controlled studies are necessary to further evaluate our findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e191 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Arnon Lavi More articles by this author Sharon Tzemah More articles by this author Genady Zelichenko More articles by this author Anan Hussein More articles by this author Ibrahim Bishara More articles by this author Michael Gross More articles by this author Michael Cohen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Dynamics of еndothelin-1 level and the development of complications in patients with acute epididymoorchitis

Dynamics of еndothelin-1 level and the development of complications in patients with acute epididymoorchitis

O36 Management of acute epididymo-orchitis – supporting two services

IntroductionThe mismanagement of acute epididymo-orchitis (EO) can have significant sequelae. Guidelines exist for the management of EO and we audited practice across two departments (Urology and Genito-Urinary Medicine [GUM]) within...

Severe Acute Epididymo-Orchitis Complicated with Abscess and Testicular Necrosis – Case Report

Severe Acute Epididymo-Orchitis Complicated with Abscess and Testicular Necrosis – Case Report

Evaluating the Necessity of Antibiotics in the Treatment of Acute Epididymitis in Pediatric Patients: A Literature Review of Retrospective Studies and Data Analysis.

This literature review and data analysis aims to evaluate the percentage of pediatric patients with acute epididymitis found to have bacterial etiology and the percentage of patients in these studies that were treated with antibiotic therapy versus conservative therapy. A search of EBSCO through January 13, 2016, using the key words epididymitis or epididymo-orchitis and child, children, or pediatric, identified 542 potential studies.Twenty-seven retrospective studies met the inclusion criteria, containing patients aged 21 years or younger with acute epididymitis or epididymoorchitis. The number and age of patients, urine cultures and urinalysis results, number of patients treated with antibiotics, and incidence were extracted. A total of 1496 patients with acute epididymitis were identified. A urinalysis was obtained for 1124 patients, and 190 (16.9%) were positive. Aurine culturewas obtained for 670 patients, and 100 (14.9%) were positive. Fourteen studies addressed antibiotic administration wherein 652 patients were with acute epididymitis and 554 (85%) received antibiotics.Of 502 patients with urinalysis results, urine culture results, and antibiotic treatment rates, 54 (10.8%) were positive for a bacterial source. Antibiotics were administered to 410 (81.7%) of these 502 patients. Practitioners should consider only prescribing antibiotics to patients with acute epididymitis if there is an abnormal urinalysis or urine culture.

CLINICAL OUTCOME OF PATIENTS WITH ACUTE SCROTAL PAIN AT A TERTIARY RURAL CENTRE IN MAHARASHTRA

Introduction: Acute scrotum is a common reason for emergency consultation. Early scrotal exploration is mandatory if torsion of the testis suspected clinically. Objectives: To study management and clinical outcome of patients admitted with acute scrotal condition. Methods: This was a prospective observational study involving 60 patients hospitalized for Acute scrotum at tertiary rural centre, from September 2014 to September 2016. Patients admitted with complaints of acute pain and swelling of scrotum irrespective of age and gender were included in the study. Patient with painless scrotal swelling and those with chronic scrotal pain were excluded from the study. Patients were monitored post-operatively till discharge and followed for 1 month for any complications. Results: Of the 60 patients in our study, acute epididymo-orchitis (36.6%) was the dominant cause of acute scrotal swelling followed by scrotal abscess (23.3%). 51.6% of the patients were managed conservatively, which were diagnosed as epididymoorchitis and haematocele. 14 patients underwent incision and drainage who diagnosed as scrotal abscess; 7 patients diagnosed as fournier's underwent debridement; 5 underwent orchidectomy or orchidopexy while 3 underwent B/L orchidopexy. Out of 8 cases of torsion of testis, bilateral orchidopexy was done in 3 cases (37.5%) in which we were able to salvage the affected testis. Out of the 60 patients, maximum patients (41 patients) required a hospital stay of 1-10 days. All patients were followed up for a period of 1month after discharge. None of the patients had any serious complications. Conclusion: Acute scrotum can be successfully managed by consevative methods after exclusion of Torsion of testis. Early exploration can salvage the testis in cases of torsion of testis. Key words: Acute orchiepididymitis; Acute scrotal swelling; Fournier's gangrene; Orchidectomy; Orchidopexy; Torsion of testis.

Greenlight (532 nm) Laser (XPS™) Photoselective Vapo-Enucleation of the Prostate: Technical Consideration and Short-Term Outcome

Objective: Despite significant improvement in the Greenlight (532 nm) laser technology, the surgical techniques did not show similar enhancements. In this video we report an approach for anatomical vaporization using enucleation-based approach: photoselective vapo-enucleation of the prostate (PVEP). The proposed advantages of this technique are that over conventional vaporization techniques are available tissue for pathologic assessment and the objective endpoints of vaporization and over transurethral enucleation techniques are shorter learning curve and simpler setup (no need for tissue morcellator). Patients and Methods: This video illustrates a stepwise approach for PVEP. Between July 2014 and October 2015, two surgeons performed 73 PVEP procedures. Surgeon A (with experience of more than 400 transurethral enucleation procedures) performed 52 procedures and surgeon B (enucleation naive) performed 21 procedures. Perioperative parameters were depicted and compared between surgeons. Patients were followed by IPSS, uroflowmetry, and residual urine estimation at 1, 4, and 12 months. Complications were reported according to modified Clavien classification. Results: Mean patients' age was 71 ± 8 years and prostate size was 88 ± 13 cc. Mean operating time was (55 ± 18 and 59 ± 19 minutes), lasing time (44 ± 16 and 48 ± 10 minutes), and used laser energy was (345 ± 112 and 381 ± 102 KJ) in surgeons A and B, respectively (p > 0.05). Mean catheter time was (1.7 ± 1 and 1.6 ± 1) days and hospital stay was (1 ± 0.6 and 1 ± 0.5) days in surgeons A and B, respectively (p > 0.05). No periprocedure blood transfusion was needed. After median of 9 (range 6–20) months follow-up, there were significant sustained improvements in all functional outcome measures at different follow-up points. One patient was readmitted for scrotal abscess after acute epididymo-orchitis. Persistent postprocedure grade 1 stress urine leak was reported in one patient. Mean postoperative prostate specific antigen reduction was 75 ± 18%. Conclusion: Greenlight laser (XPS™) PVEP is a safe, effective, and promising technique with objective end points entailing more prostate tissue removal. No competing financial interests exist. Runtime of video: 8 mins 51 secs

Acute Epididymo-orchitis-Related Global Testicular Infarction: Clinical and Ultrasound Findings With an Emphasis on the Juxta-epididymal String-of-Bead Sign.

Acute epididymo-orchitis (AEO)-related global testicular infarction (GTI) is rare. We report herein the clinical and ultrasound findings of 6 patients with AEO-related GTI. Seventeen patients with torsion-related GTI were also reviewed and compared. The echotexture of AEO-related GTI ranged from mildly inhomogeneous to diffuse heteroechoic, depending on the severity of testicular necrotic changes. All of the patients showed a juxta-epididymal string-of-bead pattern on color Doppler ultrasound, which was ascribed to patent arteries (5/6, 87%) and collateral vessels (1/6, 13%) in the tunica albuginea. There were no significant differences in age, laterality, leukocyte count, testicular volume ratio (infarcted/normal), frequencies of heteroechoic testicular parenchyma, scrotal skin thickening, and hydrocele between the 2 groups. However, the left testis was predominantly affected in both groups. Compared with torsion-related GTI, patients with AEO-related GTI had significantly longer duration from scrotal pain onset to surgery (13.5 ± 5.2 vs 2.6 ± 2.0 days, P < 0.001), a higher level of serum C-reactive protein (110.0 ± 82.0 vs 41.2 ± 35.9 mg/dL, P = 0.013), a higher frequency of the juxta-epididymal string-of-bead sign (100% vs 12%, P < 0.001), and a lower frequency of the whirlpool/knot sign (0% vs 88%, P = 0.002). Although the testis in AEO-related GTI may appear variable from mildly to extensively heteroechoic on gray-scale ultrasound, this unusual disease can be characterized by an avascular testis with a juxta-epididymal string-of-bead sign on color Doppler ultrasound.

Ameliorating Effect of Ginseng on Epididymo-Orchitis Inducing Alterations in Sperm Quality and Spermatogenic Cells Apoptosis following Infection by Uropathogenic Escherichia coli in Rats.

Epididymo-orchitis (EO) potentially results in reduced fertility in up to 60% of affected patients. The anti-inflammatory effects of Korean red ginseng (KRG) and its ability to act as an immunoenhancer in parallel with the beneficial effects of this ancient herbal medicine on the reproductive systems of animals and humans led us to evaluate its protective effects against acute EO. This animal experimental study was conducted in the Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran during 2013-2015. We divided 50 Wistar rats into five following groups (n=10 per group): i. Control-intact animals, ii. Vehicle-phosphate buffered saline (PBS) injection into the vas deferens, iii. KRG-an intraperitoneal (IP) injection of KRG, iv. EO-an injection of uropathogenic Escherichia coli (UPEC) strain M39 into the vas defer- ens, and v. EO/ KRG-injections of both UPEC strain M39 and KRG. The treatment lasted seven days. We then evaluated sperm parameters, number of germ cell layers, Johnson's criteria, germ cell apoptosis, body weight and relative sex organs weight. Acute EO increased the relative weight of prostate and seminal vesicles (P≤0.05). It also reduced sperm quality such as total motility, sperm concentration (P≤0.01), and the percentage of normal sperm (P≤0.001). Moreover, acute EO decreased Miller's (P≤0.05) and Johnsen's scores and increased apoptotic indexes of spermatogenic cells (P≤0.001). KRG treatment decreased prostate weight gain (P≤0.05) and improved the percentage of sperm with normal morphology, total motility (P≤0.01), and progressive motility (P≤0.05). The apoptotic indexes of spermatogenic cells reduced (P≤0.001), whereas both Johnsen's (P≤0.01) and Miller's criteria increased in the KRG-treated EO testis (P≤0.05). Consequently, KRG ameliorated the devastating effects of EO on the sperm retrieved from either epididymis or testicle in rats.

Testicular abscess

In the present literature review modern view on the etiopathogenesis, clinical course, diagnosis, treatment and prognosis of testicular abscess, which is a rare disease, are described. Testicular abscess develops most often as a result of acute epididymo-orchitis (more than 80% of all cases), much rarer due to testicular inversion and injury. The etiological agent is often E. coli. The disease occurs at any age, especially in immunocompromised patients. Clinical and laboratory picture of testicular abscess has symptomatic nature and consists of local and general signs of purulent inflammation. There are no pathognomonic clinical symptoms. Testicular abscess may occur under the guise of acute inguinal and scrotal area diseases, in a quarter of patients it is characterized by inapparent clinical and laboratory course, simulating testicular tumor or tuberculous orchitis. Diagnostic difficulties are caused by nonspecific clinical and laboratory characteristics and radiation patterns, disease infrequency and a lack of awareness among physicians. Suspicion of testicular abscess arise in ineffectiveness of antibiotic therapy for acute epididymo-orchitis during the first 5-7 days of disease and makes physician to perform necessary X-ray studies. The method of choice for the testicular abscess diagnosis is ultrasound examination. The diagnostic capabilities of other radiation techniques have currently been studying. Ultrasound picture of testicular abscess depending on the disease stage is varying and does not differ from the ultrasound picture of abscess of other localization. The most difficult is differential diagnosis of abscess and testicular tumors. In diagnostically ambiguous cases, ultrasound-guided percutaneous testicle biopsy or exploratory surgery are performed. Choice of treatment method is determined by the disease stage. A variety of conservative and surgical treatment methods of the testicular abscess are applied, such as antibiotic therapy, percutaneous puncture and ultrasound-guided abscess aspiration, abscessotomy and orchiectomy. Prognosis for life is favorable with timely treatment of disease.