Testicular diseases. Epididymitis And ORCHITIS : Inflammatory conditions are generally more common in the epididymis than in the testis However, some infections,notably syphilis,may begin in the testis with secondary involvement of the epididymis. Normal Anatomy.
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Epididymitis And ORCHITIS:
Inflammatory conditions are generally more common in the epididymis than in the testis
However, some infections,notably syphilis,may begin in the testis with secondary involvement of the epididymis
1.Non specific epididymitis and Orchitis:
Epididymitis and possible subsequent orchitis are commonly related to infections in the urinarytract(cystitis,urethritis,genitoprostatitis.
These infections reach the epididymis/testis through either the vas deference or the lymphatics of the spermatic cord.
Varies with age;
Children: uncommon, usually associated with a congenital genitourinary abnormality and infection with Gram –ve rods.
In sexually active men younger than age 35 years-----Chlamydia trachomatis and Neisseria
often followed by fibrous scarring.
Leydig cells are not usually destroyed.
Usually middle –aged men------unilateral testicular mass. Usually moderately tender but sometimes may present as painless testicular mass; mimicking a testicular tumor.
Microscopically: granulomas resticted within the spermatic tubules.
Although an autoimmune basis is suspected,the cause of these lesions remain unknown.
Gonorrhea: Extension of infection from the posterior urethra to the prostate to the seminal vesicles and then to the epididymis is the usual course of a neglected gonococcal infection.
Microscopy: Caseating Granulomatous inflammation.
Obliterative endarteritis with perivascular cuffing of lymphocytes and plasma cells.
-Yolk sac (endodermal Sinus) tumor
-Leydig cell tumor
-Sertoli cell tumor
-Cryptorchidism :10% of testicular tumors