CHEMOTHERAPY OF EPIDIDYMITIS

Abstract

We carried out investigation on 166 patients with nonspecific epididymitis for the past five years with particular attention to their clinical course during the therapy with antimicrobial agents. Out of the 166 patients, 152 were out-patients and 14, hospitalized. All of the latter group were complicated with epididymitis.
Escherichia coli was predominantly isolated from urine of the out-patients while Pseudomonas aeruginosa was a major organism from that of the in-patients. Except a few chronic asymptomatic cases, all patients were treated with antimicrobial agents. The drugs most frequently used for the out-patients were antibiotics of the cephamycin series (47.7%), followed by penicillins (28.8%), sulfamethoxazole-trimethoprim (11.3%) and others. A more than 4-week observation of clinical course was made on 58 acute and 9 chronic cases after chemotherapy was instituted. Most of the acute cases showed in-provement in clinical symptoms within three weeks, but in one-third of the cases, scrotal induration persisted until after eight weeks. Particularly in those from whose urine no bacteria was isolated, the scrotal induration tended to persist longer than in others. Most chronic cases responded well to the antimicrobial treatment.
Eleven of the 14 in-patients who had no vasectomy had acute epididymitis after suprapubic prostatectomy. Ten of the 14 cases were on post-operative prophylactic chemotherapy when epididymitis occurred. Aminoglycosides were the most effective antibiotics for post-operative cases, and symptoms improved within 10 days in most cases, but one case needed orchiectomy one month later because of fistula formation and persisting pus discharge.