Epididymoorchitis pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
Epididymoorchitis refers to the [[inflammation]] of the [[epididymis]] and/or [[testes]], with or without [[infection]]. While the pathogenesis is not fully understood, the following are the proposed mechanisms behind epididymoorchitis:<ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |year=2009 |pmid=19378875 |doi= |url=}}</ref><ref name="pmid18061028">{{cite journal |vauthors=Tracy CR, Steers WD, Costabile R |title=Diagnosis and management of epididymitis |journal=Urol. Clin. North Am. |volume=35 |issue=1 |pages=101–8; vii |year=2008 |pmid=18061028 |doi=10.1016/j.ucl.2007.09.013 |url=}}</ref> | Epididymoorchitis refers to the [[inflammation]] of the [[epididymis]] and/or [[testes]], with or without [[infection]]. While the [[pathogenesis]] is not fully understood, the following are the proposed mechanisms behind epididymoorchitis:<ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |year=2009 |pmid=19378875 |doi= |url=}}</ref><ref name="pmid18061028">{{cite journal |vauthors=Tracy CR, Steers WD, Costabile R |title=Diagnosis and management of epididymitis |journal=Urol. Clin. North Am. |volume=35 |issue=1 |pages=101–8; vii |year=2008 |pmid=18061028 |doi=10.1016/j.ucl.2007.09.013 |url=}}</ref> | ||
*The | *The retrograde ascent of infectious [[pathogens]] is the usual route of [[infection]]. Most cases of epididymoorchitis start with [[inflammation]] of the [[epididymis]] (i.e., epididymitis), which then spread to the adjacent [[testicle]] (i.e., orchitis). Because orchitis tends to occurs in patients with concurrent epididymitis, cases are mostly referred to as epididymoorchitis. | ||
*Isolated cases of orchitis are usually due to [[mumps]] [[virus]] and in isolated cases of orchitis, [[blood]]-borne | *Isolated cases of orchitis are usually due to [[mumps]] [[virus]] and in isolated cases of orchitis, [[blood]]-borne dissemination is the usual route of [[infection]]. | ||
* | *Retrograde flow of infected [[urine]] into the [[ejaculatory duct]] is thought to cause epididymoorchitis. | ||
*For [[infectious]] cases of epididymoorchitis that are not associated with an [[STD]] or [[UTI]], it is believed that these cases may be related a post-infectious [[inflammatory]] reaction. When taking [[viral]] | *For [[infectious]] cases of epididymoorchitis that are not associated with an [[STD]] or [[UTI]], it is believed that these cases may be related a post-infectious [[inflammatory]] reaction. When taking [[viral]] cultures of [[throat]], [[stool]] and [[urine]], it was found that patients with epididymoorchitis had elevated [[Titer|titres]] to certain [[pathogens]], as compared to controls. Most notably, patients with epididymoorchitis had elevated [[Titer|titres]] to ''[[M. pneumonia]]'' and [[adenovirus]]. | ||
*The mechanism behind non-infectious epididymoorchitis remains unclear. | *The mechanism behind non-infectious epididymoorchitis remains unclear. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Pathophysiology
Pathogenesis
Epididymoorchitis refers to the inflammation of the epididymis and/or testes, with or without infection. While the pathogenesis is not fully understood, the following are the proposed mechanisms behind epididymoorchitis:[1][2]
- The retrograde ascent of infectious pathogens is the usual route of infection. Most cases of epididymoorchitis start with inflammation of the epididymis (i.e., epididymitis), which then spread to the adjacent testicle (i.e., orchitis). Because orchitis tends to occurs in patients with concurrent epididymitis, cases are mostly referred to as epididymoorchitis.
- Isolated cases of orchitis are usually due to mumps virus and in isolated cases of orchitis, blood-borne dissemination is the usual route of infection.
- Retrograde flow of infected urine into the ejaculatory duct is thought to cause epididymoorchitis.
- For infectious cases of epididymoorchitis that are not associated with an STD or UTI, it is believed that these cases may be related a post-infectious inflammatory reaction. When taking viral cultures of throat, stool and urine, it was found that patients with epididymoorchitis had elevated titres to certain pathogens, as compared to controls. Most notably, patients with epididymoorchitis had elevated titres to M. pneumonia and adenovirus.
- The mechanism behind non-infectious epididymoorchitis remains unclear.
Gross Pathology
Microscopic Pathology
Genetics
Associated Conditions
References
- ↑ Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.
- ↑ Tracy CR, Steers WD, Costabile R (2008). "Diagnosis and management of epididymitis". Urol. Clin. North Am. 35 (1): 101–8, vii. doi:10.1016/j.ucl.2007.09.013. PMID 18061028.