Epididymis swelling

Introduction Prostate tuberculosis clinical manifestations epididymis can often be affected, swollen and hard, irregular surface, nodular, mild tenderness, and occasionally there may be vas deferens beaded nodules. When the lesion is severe, there is pain during ejaculation, blood sperm, semen reduction and sexual dysfunction.

Cause

Prostate tuberculosis is part of the entire genitourinary tuberculosis, and genitourinary tuberculosis is part of systemic tuberculosis.

The most common form of urogenital tuberculosis is kidney tuberculosis. Most other organs are secondary to kidney tuberculosis, including prostate tuberculosis. The more severe the disease of renal tuberculosis, the higher the possibility of male tuberculosis. As a secondary tuberculosis, male germline tuberculosis rarely occurs in one organ, but occurs in the prostate, seminal vesicles, vas deferens, epididymis, and testes. Therefore, prostate tuberculosis does not exist in isolation. Because epididymal tuberculosis often has clinical manifestations, it is easy to be discovered by patients or doctors at an early stage, and prostate tuberculosis is more concealed and difficult to find.

There are two ways for Mycobacterium tuberculosis to enter the prostate: (1) through the urinary tract to the posterior urethra, through the prostate orifice and the ejaculatory duct into the prostate. (2) From the distant lesions to the prostate through the blood line. Therefore, male reproductive system tuberculosis is the first to invade the prostate and seminal vesicles, and then through the vas deferens to the epididymis and testis.

an examination

Related inspection

Testicular examination of urine pathogens for prostate examination

1, early prostate tuberculosis is often asymptomatic, sometimes symptoms of chronic prostatitis, manifested as perineal discomfort and falling sense, lower back pain, anal and testicular pain, pain during stool, pain to the hips, symptoms gradually worse.

2, urine can be turbid, there is a small amount of secretions in the urethra. If the bladder neck is involved, there will be frequent urination, urgency and dysuria. There are red blood cells, pus cells, proteins and Mycobacterium tuberculosis in the urine. The epididymis can often be affected, swollen and hard, the surface is irregular, nodular, mild tenderness, and occasionally there may be vas deferens beaded nodules.

3. When the lesion is serious, there is pain during ejaculation, blood sperm, semen reduction and sexual dysfunction. When the prostate and seminal vesicles are obvious, the posterior urethra, bladder and ureteral end can be compressed, causing urethral stricture, difficulty in urinating or expansion of the upper urinary tract.

4, the results of prostate referral diagnosis and pathological changes are the same, with bilateral lesions more common.

Differential diagnosis

Although the incidence of prostate tuberculosis is the first in male reproductive system tuberculosis, early diagnosis is difficult, easy to be neglected, and needs to be identified with some common diseases.

(1) Differentiation from non-specific prostatitis: Prostatic tuberculosis, also known as tuberculous prostatitis, has the same early clinical symptoms as chronic prostatitis. It also shows an increase in pus cells in prostatic fluid, so it is difficult to distinguish clinically. It is often necessary to do smear and culture of urinary tuberculosis, as well as tuberculosis examination of semen and prostatic fluid. It should be noted that the prostate tuberculosis patients should be careful to do prostate massage, in order to prevent the spread of tuberculosis lesions, should first do semen tuberculosis test. After applying anti-spasm treatment, you can consider prostate massage for smear examination of prostatic fluid tuberculosis.

(2) Identification with prostate cancer: Prostatic tuberculosis can cause enlarged prostate, hard nodules and fixation, and is not easy to distinguish from prostate cancer. In fact, when the rectal examination is made, the mass of the prostate cancer is harder than that of the tuberculosis, and there are nodules of different sizes. If the cancer has invaded the prostate capsule, the mass is fixed. For example, serum prostate specific antigen, acid phosphatase assay and transrectal prostate aspiration biopsy are helpful for diagnosis.

(3) Identification with prostate stones: On the X-ray film, prostate calcification can be seen, which can be the performance of prostate tuberculosis, or the performance of prostate stones. However, prostate tuberculosis is often accompanied by epididymis, vas deferens tuberculosis, sputum and epididymal enlargement or beaded nodular lesions in the vas deferens. Combined with prostate fluid examination, the two are not difficult to identify.

Early prostatic tuberculosis is often asymptomatic, sometimes with symptoms of chronic prostatitis, manifested as perineal discomfort and falling sensation, lower back pain, pain in the anus and testicles, pain in the stool, pain in the hips, and the symptoms gradually worsen. The urine can be turbid and there is a small amount of secretion in the urethra. If the bladder neck is involved, there will be frequent urination, urgency and dysuria. There are red blood cells, pus cells, proteins and Mycobacterium tuberculosis in the urine. The epididymis can often be affected, swollen and hard, the surface is irregular, nodular, mild tenderness, and occasionally there may be vas deferens beaded nodules. When the lesion is severe, there is pain during ejaculation, blood sperm, semen reduction and sexual dysfunction. When the prostate and seminal vesicles are obvious, the posterior urethra, bladder and ureteral end can be compressed, causing urethral stricture, difficulty in urinating or expansion of the upper urinary tract.

The results of prostate referral diagnosis are the same as pathological changes, and bilateral lesions are more common.

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