Inflammation of vas deferens (deferentitis) most often occurs against the background of the inflammatory processes in other organs of the male reproductive system. These organs are posterior urethra, epididymis, and testicle. Often, spermatic cord is involved in the pathological process.
The disease may have different etiology. It can be caused by the sexually transmitted infections, specific or nonspecific bacteria. Sometimes it is the result of the autoimmune process. Depending on the cause of inflammation of vas deferens, various therapeutic tactics are used.
Principles of treatment
In most cases, the pathology has an infectious origin. It can be caused by specific microorganisms (gonorrhea, chlamydia, tuberculosis, syphilis) or a nonspecific bacterial flora. It includes all bacteria that are normally present in the urogenital tract, but in active reproduction or spreading into the vas deferens they can cause inflammatory processes. These bacteria are transmitted with medical instruments or come from the other foci of infection in the body.
In this case, the etiotropic therapy is required which is aimed at elimination of the main infectious focus. The antibacterial drugs are used. Specific type of the remedy depends on the identified pathogen.
Before prescribing the etiotropic treatment of the vas deferens inflammation the diagnostic tests should be carried out. Their aim is to determine the type of pathogen. Only in this case it will be possible to obtain a good treatment result, since different antibiotics have different spectrum of action and destroy various bacteria.
If the severe purulent inflammation in the vas deferens is detected, surgical treatment may be required. Otherwise, an abscess opens, pathological connections form between the organs (fistula), and infection spreads to other anatomical zones.
Sometimes deferentitis has an autoimmune nature. It occurs as a result of the blood-testis barrier violation. Most often, it occurs as a result of surgical intervention, trauma, or severe inflammation. The genotype of spermatozoa differs from the genetic composition of male somatic cells. The immune system does not attack them only because of the blood-testis barrier protection that separates the scrotum organs from the circulatory system of the human body. If the barrier is damaged, the antisperm antibodies will be produced. A chronic inflammatory process develops. It may not be accompanied by severe symptoms, but leads to infertility. In this situation, the treatment is carried out only if a patient wants to preserve fertility and have children in the future.
Antibacterial treatment in genital infections
Before prescribing antibiotics, the laboratory examinations are carried out. Microscopy of urogenital smear is performed, as well as the urethral scraping followed by a PCR (polymerase chain reaction) examination for common sexually transmitted infections. Such diseases as chlamydia, gonorrhea, trichomoniasis are also excluded with the help of laboratory tests. It is also recommended to perform blood test for syphilis.
The very next day, in the course of these diagnostic measures, a doctor can identify which pathogens are present in the body, if there are any. Then, treatment is selected.
Cephalosporin antibiotics are prescribed in case of gonococcal infection. Most often, this is ceftriaxone, since gonococci have high sensitivity to it. Consequently, the treatment almost always ends with a recovery after the first course of therapy.
Gonorrhea with the development of vas deferens inflammation is considered as a complicated one. On average, deferentitis begins in 4 weeks after the acute gonococcal urethritis. But there are some cases when the duct becomes inflamed only in several months. Ceftriaxone treatment lasts 10-14 days. It is administered intramuscularly, 1 gram per day.
In inflammation of chlamydial etiology, treatment should begin as soon as possible, especially in case of a bilateral process, as chlamydiae often initiate pronounced cicatricial changes. As a result of the vas deferens inflammation, the obstructive infertility may develop in a man. At the same time, fertility is not always restored even after the treatment of Chlamydia. This is connected with formation of scars that prevent movement of spermatozoa from testicles to urethra.
Chlamydial infection is treated with one of the three antibiotic groups. Tetracyclines (doxycycline) or macrolides (josamycin) are most common. Fluoroquinolones (levofloxacin) are used less commonly.
Treatment in nonspecific deferentitis
Sometimes it may happen that the sexually transmitted infections are not detected during the examination. In men, vas deferens inflammation can be caused by a nonspecific bacterial flora. It spreads into the deferens from:
- Prostate gland
- Distant purulent foci in the body (through the blood or lymphatic system)
In this case, the bacterial swab test is carried out. The type of bacteria which cause the inflammation is determined. Sensitivity of revealed flora to antibiotics is assessed. Then the drug to which the identified bacteria have the maximum sensitivity is prescribed for the treatment.
In case of acute purulent inflammation, therapy is prescribed empirically (without antibiogram) on the day of admission. This is required for the prevention of complications. Further, the antibiotic can be changed based on the results of bacterial swab test.
Sometimes a significant purulent inflammation develops. Up to 200 ml of pus can be accumulated in the spermatic duct and surrounding tissues. In this case, a surgery has to be performed. A doctor makes excision and drains the duct. Pus is removed; the wound is washed with antiseptics. The antibiotic therapy is performed simultaneously.
Treatment in Germany
The company Booking Health offers treatment in the best German hospitals in inflammation of the vas deferens. In German medical institutions both conservative and surgical treatment methods are used in order to solve the problem of deferentitis as soon as possible.
The advantages of treatment in German hospital:
- Accurate diagnostics that allows determining the type of pathogen and identify or eliminate sexually transmitted infections.
- Etiotropic therapy using the modern antibacterial drugs.
- Performing surgical treatment, if necessary. Operations are carried out by the internationally recognized experts.
- Minimal risk of fertility disturbances in case of surgical treatment.
- In the case of obstructive infertility development, it is possible to perform the reconstructive operations on the vas deferens, restoring natural fertility of man.
Specialists of Booking Health will select the best hospital and treatment program for you. While selecting a medical institution, the statistics on this disease and costs of treatment will be taken into account. Thanks to Booking Health, you will save on medical services and get medical care faster. In addition, the company solves all the organizational issues. Therefore, all you have to do is to focus on the restoration of your health.
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova