1Department of Sanitation and Antiepidemic, China; 2Department of
Urology, The First Affiliated Hospital, Xi'an Jiaotong University, School
of Medicine, Xi'an 710061, PR China
Objective: To describe the clinical characteristics of isolated
tuberculous epididymitis and to profile its diagnosis and
treatment in this group of patients.
Methods: A retrospective case study of the hospital records
of patients with epididymal tuberculosis managed at the first
affiliated Hospital of Xi'an jiaotong university, school of medicine
in Xi'an, Northwest of China during the period of 2001-2011.
Results: 68 were found to have isolated tuberculous
epididymitis. The mean age was 34.5 years. The main
presentation was incident induration an insidious onset of
painful scrotal swelling, mostly on the left side. Mean duration
of symptoms was 10.6 weeks. Most patients had no history of
previous tuberculosis and no Mycobacterium Tuberculosis in
their urine. Six months of anti-tuberculous chemotherapy was
effective, combined with surgery for scrotal abscesses. Although
all patients recovered, the results on fertility are considerable.
Conclusions: Isolated tuberculous epididymitis is the most
common form of genitourinary tuberculosis. The treatment
of choice is primarily medical, consisting of a combination of
three or four anti-TB drugs, sometimes combined with surgery
for large scrotal abscesses. The fertility outcome is of concern.
Sperm retrieval and cryopreservation have to be considered for
potential intra-cytoplasmic sperm injection.