{Reference Type}: Journal Article
{Title}: Diagnosis and treatment of epididymal tuberculosis: a review of 47 cases.
{Author}: Man J;Cao L;Dong Z;Tian J;Wang Z;Yang L;
{Journal}: PeerJ
{Volume}: 8
{Issue}: 0
{Year}: 2020
{Factor}: 3.061
{DOI}: 10.7717/peerj.8291
{Abstract}: <B>OBJECTIVE: </B>To analyze the clinical manifestations, diagnosis and treatment outcomes in a series of patients with epididymal tuberculosis.<BR><B>METHODS: </B>This study is a retrospective data analysis of 47 cases of histologically-confirmed epididymal tuberculosis in patients treated at our hospital from November 2012 to December 2018.<BR><B>RESULTS: </B>The average age of the patients was approximately 42 years. The epididymal lesion location was left-sided in 15 patients (31.9%), right-sided in 22 patients (46.8%) and bilateral in 10 patients (21.3%). The main symptoms were painless swelling of the scrotum in 21 cases (44.7%) and scrotal drop pain in 21 cases (44.7%). Scrotal physical examination revealed epididymal beaded enlargement in 12 patients (25.5%), testicular mass in one patient (2.1%), scrotal tenderness alone in seven patients (14.9%), ill-defined epididymal-testicular border in 21 patients (44.7%) and sinus formation in six patients (12.8%). After 2-4 weeks of anti-tuberculosis chemotherapy, the patients underwent a surgical procedure. We found that 10 (83.3%) of the 12 patients whose main symptom was epididymal beaded enlargement underwent simple epididymal surgery. Of the 21 patients whose main clinical manifestation was ill-defined testis-epididymis demarcation, 16 (72.2%) underwent epididymis-testicular surgery. All patients underwent postoperative chemotherapy for 3-6 months. Postoperative follow-up showed good response to treatment.<BR><B>CONCLUSIONS: </B>It is difficult to diagnose early-stage epididymal tuberculosis. Epididymal tuberculosis is likely to have invaded surrounding tissues when signs such as epididymal beaded changes and ill-defined epididymis-testis border are present. Surgical treatment combined with preoperative and postoperative chemotherapy is an effective approach to treating this condition.