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Depuydt CE, Bosnians E, Zalata A, Schoonjans F, Comhaire FH.The relation between reactive oxygen species and cytokines in andrological patients with or without male accessory gland infection. J Androl 1996; 17: 699-707. 41. Weidner W, Ludwig M, Miller J.
The effect of doxycycline in infertile couples with male accessory gland infection: a double blind prospective study. Int J Androl 1986; 9: 91-98. ORCHITIS AND EPIDIDYMITIS Orchitis Orchitis is an inflammatory lesion of the testicle associated with a predominantly leukocytic exsudate inside and outside the seminiferous tubules resulting in tubular sclerosis. The inflammation causes pain and swelling. Chronic inflammatory changes in the seminiferous tubules disrupt the normal process of spermatogenesis and cause alterations both in sperm number and quality [1]. It is generally accepted that orchitis may also be an important cause of spermatogenetic arrest [2], which may be reversible. Following orchitis, testicle atrophy occurs [2].
Diagnosis Patients with epididymo-orchitis usually present with unilateral scrotal pain [4]. The diagnosis is based on medical history and palpation. Ultrasonography demonstrates a swollen, enlarged testis. The sonographic feature of the tissue does not allow any differential diagnosis [5]. Ejaculate analysis Ejaculate analysis, including leukocyte analysis, indicates persistent inflammatory activity (see above Androlo-gical investigations and spermatology). In many cases, especially in acute epididymo-orchitis, transiently decreased sperm counts and reduced forward motility are observed [2]. Obstructive azoospermia due to complete obstruction is a rare complication. Mumps orchitis may result in bilateral testicular atrophy [3] and testicular azoospermia. When granulomatous orchitis is suspected, sperm-bound autoantibodies occur (see above Andrological investigations and spermatology). Therapy
In mumps orchitis, systemic interferon alpha-2b therapy has been reported to prevent testicular atrophy and azoospermia [7]. In idiopathic granulomatous orchitis, surgical removal of the testis is the therapy of choice. Date: 2016-06-12; view: 346
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