Studies on Tuberculosis of the Epididymis: 1. Clinical observation on tuberculosis of the Epididmis

Lee, Jhy Bok; Lee, Hak Song; Lee, Chae Koo

Abstract

Two-hundred and fourteen cases of tuberculosis of the epididymis seen during the period from April 1957 to March 1965 were studied clinically and the following results were obtained: (1) Incidence of tuberculosis of the epididymis is 1.4% of all urological diseases or 22.4% of tuberculosis of the urinary tract of the male. (2) The highest occurrence is observed in the ages of 20 to 39(75.7%) and the lowest in the ages below 9 and above 60 (0.9%) respectively. (3) Lateralization shows 31.8% in the right, 24.3 % in the left and 43.9 % in the both. The site of invasion is most popular in the tail (47.8 %) and the size up to thumb size was observed in 89.4 %. (4) Discovery of tuberculous invasion in the remainder following unilateral epididymal lesion is made within 2 years 7 months. Transfer of tuberculosis of the other organ to the epididymis requires 6 years 3 months. (5) In 42.9 %, tuberculous diseases were present in the past history ; The pleura, the lung and the urinary tract were most frequently invaded. (40.6 %) (6) Approximately half of the cases requested medical care within one month after discovery of the lesion. (7) Of presenting symptoms, swelling of the epididymis was observed in 73.8 %, frequency of urination 27.1 % and hematuria in 20.1 %. (8) Three or more c.c. of ejaculate were observed in 24.1 %, counting of sperm disclosed azoospermia in 41.4 % oligospermia in 35.5 % and normospermia in 20.7 %. (9) In urine examination, W. B. C. 5/H. P. F. or more is observed in 70.7 %, RBC 3/H. P. F. or more in 40.5 %, albumin in 61 % and tubercle bacilli in 27.4 %. (10) In prostatic smear, WBC 10/H.P.F. or more is observed in 69.7 %, RBC 5/H.P.F. or more in 18.3 % and tubercle bacilli in 7.7 %. (11) Proatatic tuberculosis is the commonest complication of epididymal tuberculosis (67,8 %). (12) Local injection with 0.3-0.5 cc of 30 % streptomycid solution directly in the lesion appeared to be very effective in 11 of 13 cases. This treatment is to be used prior to surgery.