Okuqukethwe
I-Epididymitis iyisilonda esivuthayo sokwakheka okukhethekile okubukeka njengeshubhu elincane elitholakala ngenhla nangemuva kwe-testicle futhi lisebenzela ukukhuthaza nokuvuthwa kwe-spermatozoa - i-epididymis (epididymis).
I-epididymitis evame kakhulu emadodeni aneminyaka engu-19 - 35 iminyaka. I-Pathology kule minyaka iyimbangela evamile yokulaliswa esibhedlela. Kancane kancane, lesi sifo sibhalwa kubantu asebekhulile, futhi i-epididymitis cishe ayiveli ezinganeni.
Izinhlobo nezimbangela ze-epididymitis
Lesi sifo singaba nezimbangela eziningi ezihlukene, zombili ezithathelwanayo (ngenxa yemiphumela ye-pathogenic yamagciwane, amabhaktheriya, isikhunta), kanye nezingatheleleki. I-bacterial epididymitis ivame kakhulu. Kukholelwa ukuthi kubantu abasha (iminyaka engu-15 - 35), lesi sifo sivame ukucasulwa izifo ezithathelwana ngocansi (STIs), njenge-chlamydia, i-gonorrhea, njll. Kubantu asebekhulile nasezinganeni, inkinga ihlotshaniswa nama-microorganisms avame ukubangela. izifo zesistimu yomchamo (isibonelo, i-enterobacteria). Isizathu se-epididymitis singabuye sibe yi-pathologies ethize, njengesifo sofuba (i-tuberculous epididymitis), njll.
Kwesinye isikhathi i-pathogenic enemibandela (ehlala ikhona emzimbeni, kepha hhayi evame ukuholela esifweni) ukhunta wohlobo lweCandida iba yi-causative agent ye-pathology, bese bekhuluma nge-candidal epididymitis. Kulokhu, ukusetshenziswa okungenangqondo kwama-antibiotics, ukwehla kokuzivikela komzimba kungavusa ukuthuthukiswa kwalesi sifo.
Mhlawumbe ukuvela kwenqubo ye-pathological ku-epididymis ngokumelene nesizinda: • ama-mumps ("ama-mumps") - ukuvuvukala kwezindlala ze-parotid; • i-angina; • umkhuhlane; • inyumoniya; • ikakhulukazi ngokuvamile ukutheleleka kwezitho eziseduze - i-urethritis (i-pathology yokuvuvukala kwe-urinary canal), i-vesiculitis (i-seminal vesicles), i-prostatitis (i-prostate gland), njll.
Ngezinye izikhathi ukutheleleka kuphinde kungene ku-appendage ngenxa yezinqubo ezithile: i-endoscopy, i-catheterization, i-bougienage ye-urethra (inqubo yokuxilonga eyenziwa ngokwethula ithuluzi elikhethekile - i-bougie).
I-epididymitis engatheleleki, isibonelo, ingenzeka: • uma ulashwa ngomuthi onjenge-Amiodarone we-arrhythmias; • ngemva kokuvala inzalo ngokususa/ukuxhunywa kwe-vas deferens (ngenxa yokunqwabelana kwe-spermatozoa engahluziwe) – i-granulomatous epididymitis.
Kukhona acute (ubude besikhathi lesi sifo abukho ngaphezu kwamaviki angu-6) kanye ne-epididymitis engapheli, ebonakala ngesilonda esivelele kuzo zombili izithasiselo, ngokuvamile iqala ngezilonda zofuba, i-syphilis (isikhathi esingaphezu kwezinyanga eziyisithupha).
Ngokuya ngobunzima bokubonakaliswa, i-epididymitis ethambile, emaphakathi futhi eqinile iyahlukaniswa.
Izingozi Zezingozi
Njengoba i-epididymitis ngokuvamile iwumphumela we-STIs, isici esiyinhloko esiyingozi ekuthuthukisweni kwe-pathology ubulili obungavikelekile. Ezinye izikhathi ezivusa inkanuko: • ukulimala kwe-pelvis, i-perineum, i-scrotum, okuhlanganisa ngenxa yokuhlinzwa (i-adenomectomy, njll.); • i-anomalies ekuthuthukiseni uhlelo lwe-urogenital; • ukuphazamiseka kwesakhiwo se-urinary tract (izimila, i-prostate hyperplasia, njll.); • ukungenelela kwakamuva kokuhlinzwa ezithweni zomchamo; • ukukhwabanisa kwezokwelapha - ukuvuselela kagesi (lapho ukufinyezwa kwe-multidirectional ye-vas deferens kwenzeka, okungase kubangele "ukuncela" kwamagciwane avela ku-urethra), ukumnika izidakamizwa ku-urethra, catheterization, massage, njll; • i-prostate hyperplasia; • ama-hemorrhoids; • ukuphakamisa izisindo, ukucindezeleka ngokomzimba; • Ukuphazamiseka kwe-coitus njalo, ukuqhanyelwa ngaphandle kokuya ocansini; • ukwehla kwezivikelo zomzimba ngenxa ye-pathology engathí sina (isifo sikashukela, i-AIDS, njll.), i-hypothermia, ukushisa ngokweqile, njll.
Izimpawu ze-epididymitis
Ukuqala kwalesi sifo kubonakala njengezimpawu ezinzima, okuthi, lapho kungabikho ukwelashwa okwanele, kuvame ukubi kakhulu. Nge-epididymitis, kungase kube khona: • ubuhlungu obunzima ohlangothini olulodwa lwe-scrotum / ku-testicle nge-irradiation engenzeka ku-groin, i-sacrum, i-perineum, i-back back; • ubuhlungu obunzima endaweni ethintekile; • ubuhlungu be-pelvic; • ubomvu, ukwanda kokushisa kwendawo ye-scrotum; • ukuvuvukala/ukwenyuka kosayizi, ukuqina kwe-appendage; • ukwakheka kwe-tumor ku-scrotum; • amakhaza nomkhuhlane (kufika ku-39 degrees); • ukuwohloka jikelele kwempilo (ubuthakathaka, ukulahlekelwa ukudla, ikhanda); • ukwanda kwama-lymph nodes inguinal; • ubuhlungu ngesikhathi sokuchama, ukuhlanza; • ukwanda kokuchama, ukuphefumula okungazelelwe; • ubuhlungu ngesikhathi socansi kanye ne-ejaculation; • ukubonakala kwegazi esidodeni; • ukuphuma epipini.
Uphawu oluthile lokuxilonga ukuthi ukuphakama kwe-scrotal kungase kuholele ekukhululekeni kwezimpawu (uphawu luka-Pren oluhle).
Esikhathini esingapheli sesifo, izimpawu zenkinga zingase zingabizi kakhulu, kodwa ubuhlungu nokwanda kwe-scrotum, futhi ngokuvamile nokuchama njalo, kuyaqhubeka.
Okubalulekile! Ubuhlungu obukhulu emasendeni buyinkomba yokunakekelwa kwezokwelapha ngokushesha!
Izindlela zokuxilonga nokuhlonza isifo
Isinyathelo sokuqala sokuxilonga ekwenzeni ukuxilongwa wukuhlolwa kukadokotela ohlangothini oluthintekile lwe-testicle, ama-lymph nodes ku-groin. Uma i-epididymitis ngenxa yokwanda kwe-prostate kusolwa, ukuhlolwa kwe-rectal kwenziwa.
Ngaphezu kwalokho, kusetshenziswa izindlela zaselabhorethri: • gcoba umgudu womchamo ukuze kuhlaziywe i-microscopic kanye nokuhlukaniswa kwe-causative agent ye-STIs; • Ukuxilongwa kwe-PCR (ukutholwa kwe-pathogen nge-polymerase chain reaction); • ukuhlaziywa kwegazi kwezokwelapha kanye ne-biochemical; • i-urinalysis (okujwayelekile, "isivivinyo senkomishi ye-3" ngokuchama okulandelanayo ku-3 izinkomishi, isifundo samasiko, njll.); • ukuhlaziywa koketshezi lwesidoda.
Ukuxilongwa kwezinsimbi kuhilela lokhu okulandelayo: • I-Ultrasound ye-scrotum ukuze kutholakale izilonda, isigaba sokuvuvukala, izinqubo zesimila, ukuhlolwa kwesivinini sokugeleza kwegazi (ucwaningo lwe-Doppler); • ukuskena kwe-nuclear, lapho umthamo omncane we-radioactive ujovwe futhi ukugeleza kwegazi emasendeni kuqashwe kusetshenziswa imishini ekhethekile (ivumela ukuxilonga i-epididymitis, i-testicular torsion); • i-cystourethroscopy - isingeniso nge-urethra yensimbi yokubona, i-cystoscope, ukuhlola indawo yangaphakathi yesitho.
I-computed tomography kanye ne-magnetic resonance imaging ayisetshenziswa kakhulu.
Ukwelashwa kwe-epididymitis
Ukwelashwa kwe-epididymitis kwenziwa ngokuqinile ngaphansi kokuqondiswa kochwepheshe - i-urologist. Ngemuva kokuhlolwa, ukuhlonza i-pathogen, isikhathi eside, kuze kube yinyanga noma ngaphezulu, inkambo yokwelashwa ngama-antibiotic inqunyiwe.
Amalungiselelo akhethiwe kucatshangelwa ukuzwela kwe-microorganism ye-pathogenic, uma uhlobo lwe-pathogen alukwazi ukusungulwa, khona-ke i-agent ye-antibacterial ebanzi isetshenziswa. Izidakamizwa eziyinhloko ezikhethwa yi-epididymitis, ikakhulukazi phambi kwamanye ama-pathologies avela ohlelweni lwe-urogenital nasebasha, ama-antibiotic eqembu le-fluoroquinolone. I-Tetracyclines, i-penicillin, i-macrolides, i-cephalosporins, izidakamizwa ze-sulfa nazo zingase zibekwe. Esimeni lapho isifo sibangelwa i-STI, ukudlula ngesikhathi esisodwa kokwelashwa ngumlingani wezocansi wesiguli kuyadingeka.
Futhi, ukukhulula inqubo yokuvuvukala nokuphumula kobuhlungu, udokotela utusa izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala (njenge-indomethacin, nimesil, diclofenac, njll.), ngobuhlungu obunzima, ukuvinjelwa kwe-novocaine kwentambo yesidoda kwenziwa. Kungase futhi kunconywe: • ukuthatha amavithamini; • i-physiotherapy; • i-enzymatic, absorbable (lidase) namanye amalungiselelo.
Ngenkambo encane yesifo, ukulaliswa esibhedlela akudingeki, kodwa uma isimo siba sibi (izinga lokushisa likhuphuka ngaphezu kwama-degrees angu-39, ukubonakaliswa kokudakwa okujwayelekile, ukwanda okukhulu kwe-appendage), isiguli sithunyelwa esibhedlela. Uma ungekho umphumela, kungase kudingeke i-antibiotic ehlukile. Uma lesi sifo siphikelela, ikakhulukazi ngezilonda zamazwe amabili, kukhona ukusola kwesifo sofuba se-pathology. Esimweni esinjalo, ukubonisana nodokotela we-phthisiourologist kuyadingeka futhi, lapho kuqinisekiswa ukuxilongwa, ukuqokwa kwezidakamizwa ezithile zokulwa nesifo sofuba.
Ukwelashwa kwefomu elingapheli kwenziwa ngendlela efanayo, kodwa kuthatha isikhathi eside.
Ngaphezu kokuphuza imithi, isiguli kufanele sihambisane nemithetho elandelayo: • qaphela ukuphumula kombhede; • ukunikeza indawo ephakeme ye-scrotum, isibonelo, ngokusebenzisa ithawula eliphothiwe libe yirola; • ungafaki ukuphakamisa izinto ezisindayo; • gcina ukuphumula okuphelele kocansi; • ungafaki ukusetshenziswa kokudla okubabayo, okunamafutha; • qinisekisa ukuthi uthola uketshezi olwanele; • gcoba ama-cool compresses/ice ku-scrotum ukuze uqede ukuvuvukala; • gqoka i-suspensorium - ibhandishi elikhethekile elisekela i-scrotum, eliqinisekisa ukuphumula kwe-scrotum, livimbele ukuthi linganyakazi lapho lihamba; • Gqoka izikhindi eziqinile ezinwebekayo, iziqu zokubhukuda (zingasetshenziswa kuze kuphele izimpawu zobuhlungu).
Njengoba isimo sithuthuka, ukuvivinya umzimba okulula okujwayelekile kuvunyelwe: ukuhamba, ukugijima, ngaphandle kokuhamba ngebhayisikili. Kubalulekile ukugwema i-hypothermia evamile neyendawo phakathi nesigaba sokwelashwa futhi ekupheleni kwayo.
Ngemva kokuqeda inkambo yokwelashwa ngama-antibiotic, ngemva kwamasonto angaba ngu-3, kufanele uthintane nodokotela ukuze uphinde uhlolwe (umchamo, i-ejaculate) ukuze uqinisekise ukuqedwa okuphelele kokutheleleka.
Imithi yendabuko ingasetshenziswa kuphela njengesengezo esifundweni esiyinhloko sokwelapha futhi kuphela ngemva kwemvume kadokotela okhona. Abelaphi bendabuko abane-epididymitis batusa ukusebenzisa ama-decoctions kusuka: • iqabunga le-lingonberry, izimbali ze-tansy, i-horsetail; • amaqabunga e-nettle, i-mint, i-linden blossom namanye amalungiselelo e-herbal.
Ngokuthuthukiswa kwenkinga enjalo njenge-abscess purulent, ukuvulwa kokuhlinzwa kwe-suppuration kwenziwa. Ezimweni ezimbi kakhulu, kungase kudingeke ukususa ingxenye noma yonke i-appendage ethintekile. Ukwengeza, ukuhlinzwa kusetshenziselwa: • ukulungisa ukungahambi kahle ngokomzimba okubangela ukuthuthukiswa kwe-epididymitis; • uma kukhona okusolakala ukuthi i-testicular torsion/attachment (hydatids) ye-epididymis; • kwezinye izimo nge- tuberculous epididymitis.
Izinkinga
Njengomthetho, i-epididymitis iphathwa kahle ngemithi elwa namagciwane. Kodwa-ke, ngokungabikho kokwelashwa okwanele, izinkinga ezilandelayo zingase zithuthuke: • ukuguqulwa kwe-pathology kufomu elingapheli; • ukwenzeka kwesilonda samazwe amabili; • i-orchiepididymitis - ukusabalala kwenqubo yokuvuvukala ku-testicle; • i-abscess testicular (i-purulent, ukuvuvukala okulinganiselwe kwezicubu zesitho); • ukuthuthukiswa kokunamathela phakathi kwe-testicle ne-scrotum; • i-testicular infarction (i-tissue necrosis) ngenxa yokungasebenzi kahle kwegazi; • i-atrophy (ukwehla kobukhulu be-volumetric, okulandelwa ukwephulwa kokukhiqizwa kwesidoda kanye nokwehla kokukhiqizwa kwe-testosterone) kwamasende; • ukwakheka kwe-fistula (imisele emincane ye-pathological ene-purulent discharge) ku-scrotum; • Ukungatholi abantwana kuwumphumela wakho kokubili ukuncipha kokukhiqizwa kwesidoda kanye nokwakheka kwezithiyo ekuqhubekeleni phambili okuvamile kwesidoda.
Ukuvimbela i-epididymitis
Izinyathelo eziyinhloko zokuvimbela i-epididymitis zihlanganisa: • indlela yokuphila enempilo; • ucansi oluphephile; • wayala ukuphila kocansi; • ukutholakala ngesikhathi kanye nokuqedwa kwezifo eziphindaphindiwe zomchamo; • ukuvimbela ukulimala kwamasende (ukugqoka izinto zokuzivikela lapho uzilolongela imidlalo ehlukumezayo); • ukugcinwa kwezidingo zokuhlanzeka komuntu siqu; • ukukhishwa kwe-overheating, hypothermia; • ukuvimbela/ukwelashwa okwanele kwezifo ezithathelwanayo (kuhlanganise nokugoma umvukuzane), njll.