Prevention of Epididymitis after Prostatectomy by Prophylactic Antibiotics and Partial Vasectomy

Reeves, James F.; Scott, Richard E.; Scott, F. Brantley

doi:10.1016/s0022-5347(17)64002-3

Cited by 12 publications

(1 citation statement)

References 19 publications

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“…Tuberculous vasitis may occur with or without tuberculosis elsewhere in the genitourinary tract and typically presents with a scarred 'string of pearls' vas deferens [Jacob et al 2008;Veenema and Lattimer 1957]. Acute bacterial and suppurative vasitis have also been described occurring in isolation or with concomitant genitourinary infection elsewhere [Bissada et al 1976;Reeves et al 1964;Ryan and Harte 1988;Veenema and Lattimer 1957]. An acute inflammatory reaction of the vas deferens causing vasal obstruction and infertility has also recently been associated with herniorrhaphy using mesh [Shin et al 2005].…”

Section: Introductionmentioning

confidence: 99%

Clinically Symptomatic Vasitis: Clinical Correlations in a Rare Condition

Clavijo

Rose‐Nussbaumer

Turek

2010

Systems Biology in Reproductive Medicine

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Vasitis, or inflammation of the vas deferens, is a rare condition. When diagnosed pathologically, it has been linked to vasectomy, prostatectomy, and herniorrhaphy. When diagnosed clinically, relationships with potential causative factors are unclear. We investigated the clinical factors associated with clinically symptomatic vasitis in a retrospective series of patients. From the history, physical examination, and clinical course, we analyzed associated risk factors. Clinical care patterns were also examined to assess the effectiveness of different treatments. Among 11 patients, the mean patient age at presentation was 47 years (range 29-60 years). The mean diameter of the affected vas deferens was 0.97 cm. Associated procedures included ipsilateral herniorrhaphy (4 patients), radical prostatectomy (2 patients), perianal fistulectomy (1 patient), and bilateral testicular biopsy (1 patient). Furthermore, epididymitis was reported in one patient after testicular trauma, and another patient had congenital unilateral absence of the vas deferens. No patient had a history of vasectomy. Three patients were HIV positive and 6 were active smokers. Six of the 11 patients improved with medical management that included nonsteroidal and steroidal anti-inflammatories and antibiotics. One patient was lost to follow-up. Similar to studies of pathologically detected vasitis, this unique study of clinical vasitis suggests that prior herniorrhaphy, prostatectomy, and possibly HIV infection may be risk factors for its development. In addition, the use of anti-inflammatories and antibiotics warrants further investigation as potentially effective treatments.

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