eMedicine Specialties > Urology > Infections and Related Inflammatory Conditions

Epididymal Tuberculosis: Follow-up

Author: J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
Contributor Information and Disclosures

Updated: Nov 21, 2008

Follow-up

Further Outpatient Care

  • Patients treated for epididymal tuberculosis should be monitored for resolution of symptoms and swelling of induration, which should begin within a few weeks.
  • The urine generally clears of infectious organisms within 2 weeks.
  • Patients should engage in sexual activity only when protected by a condom because semen can be infected with mycobacterium and may transmit the disease venereally.

Complications

  • Complications of advanced tuberculous epididymitis include epididymal abscess and fistula formation.
  • Both complications are usually treated with scrotal surgery. Failure of the antituberculous regimen to achieve satisfactory local response is also treated surgically.
  • Patients may become infertile, either because of extensive duct destruction or because of obstruction of the vas deferens.

Prognosis

  • Scrotal surgery may be required, which could include removal of the epididymis and testicle.
  • The ultimate prognosis is determined by the degree of systemic illness.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Fine-needle aspiration of the epididymis may be useful to distinguish epididymal tuberculosis from bacterial epididymo-orchitis, but, because of the risk of tumor spillage, fine-needle aspiration should be avoided if a neoplasm is suspected.
  • The typical presentation of acute tuberculous epididymitis usually prompts antibiotic therapy for presumed acute bacterial epididymo-orchitis. A more insidious onset of symptoms, although not suggestive of acute bacterial epididymo-orchitis, often prompts the same therapy because tuberculosis is usually not considered by the treating physician.
  • Because tuberculous epididymitis often goes unsuspected during management of refractory epididymo-orchitis in developed countries, the ultimate diagnosis of tuberculous epididymitis usually is made when the pathological specimen from epididymo-orchiectomy is examined.
 


More on Epididymal Tuberculosis

Overview: Epididymal Tuberculosis
Differential Diagnoses & Workup: Epididymal Tuberculosis
Treatment & Medication: Epididymal Tuberculosis
Follow-up: Epididymal Tuberculosis
References
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References

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Further Reading

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Keywords

epididymal tuberculosis, epididymal TB, tuberculous epididymitis, genital tuberculosis, genital TB, genitourinary tuberculosis, genitourinary TB, mycobacterial tuberculosis, Mycobacterium tuberculosis, MTB, granulomas, extrapulmonary tuberculosis, nonpulmonary tuberculosis, extrapulmonary TB, nonpulmonary TB, male genital tuberculosis, male genital TB

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Contributor Information and Disclosures

Author

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Medical Editor

Martha K Terris, MD, FACS, Professor, Department of Surgery, Medical College of Georgia
Martha K Terris, MD, FACS is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Institute of Ultrasound in Medicine, American Urological Association, New York Academy of Sciences, and Society of University Urologists
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Edward David Kim, MD, FACS, Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

 
 
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