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- Fri Jul 23, 2010 3:08 pm
I had bilateral Varicocelectomy in april 2009 for infertility reasons. then by July my we've got a baby girl:-)
Approx. in marsh 2010 i felt like small hard lump on the upper side of the left testis then it was associated with pain and enlarged somehow. i went to see the doctor "who did the Varicocelectomy to me" and he said - after having semen / urin analysis and culture + Ultra sound - it is epididymitis "on the head of the left eppid.". knowing that the S&U analysis and culture gave normal results "no infiction, pus, RBC, WBC, or bacterial presence. only UltraSound give the indication". and he gave me antibiotics for 20 and said the swilling will not go. now i don't feel the pain, although it is uncomfortable and some few times it tickles me. and now i am feeling that the tail of my right eppid. has the same feeleing "swilling and tickling especially during sexual intercourse". to confirm, I went to other urology doctors and all gave the same diagnosis after Ultrasound only.
my questions now are, is this a consequence of the Varicocelectomy? is it true that the swelling can't be removed? what is the cause of it if the semen/urin analysis showed nothing? shall i live with it peacefully?
Thanks a lot for your support,
| Dr.M.Aroon kamath
- Sat Jul 24, 2010 9:51 pm
Firstly let me congratulate you for the successful outcome of the varicocelectomy. Varicocelectomy per-se, is not expected to cause an epididymitis.
In clinical practice,one tends to classify epididymitis into
- acute and
- chronic types.
The pathogenesis of epididymitis in general, and chroinc epididymitis in particular is poorly understood. Although generally believed to be an infective process, a sizable number of these patients show no demonstrable evidence of infection.
There is no universally accepted definition for "chronic" epididymitis. Its incidence and prevalence have not been well studied.It remains a "common and important, but neglected, urologic diagnosis.Some workers have recommended that it should be defined as "symptoms of discomfort and/or pain at least 3 months in duration in the scrotum, testicle, or epididymis localized to one or each epididymis on clinical examination" (Rev Urol. 2003 Fall; 5(4): 209–215.).
An epididymitis (inflammation of the epididymis), generally regarded to be due to a retrograde entry of organisms via the vas deferens. This affects the tail of the epididymis first,then its body and then its head.The swelling may persist for varying lengths of time despite adequate treatment.
Varicocelectomy is not an accepted cause of epididymitis.
You have not indicated whether the ultrasound report indicated an "acute" or a "chronic" epididymitis. In your case,it is important first to determine whether your symptoms are indeed as a result of epididymitis.
Epididymectomy certainly feasible and in several studies it is shown to be beneficial in relieving the symptoms of 'chronic' epididymitis.
In uncomplicated acute epididymitis, management is in most cases, non-operative.
I feel that you should quit worrying excessively and let your doctor deal with it based on the clinical findings and the results of the various tests.