Nonspecific epididymitis and orchitis:
Nonspecific epididymitis and orchitis are often associated with infection of the urinary tract, with secondary infection of the epididymis via vas deferens or lymphatics of the spermatic cord.
Causes vary with the age of the patient and include:
i) In pediatric patients it is usually associated with genitourinary malformations.
ii) In sexually active men, younger than age 35 years of age, the sexually transmitted pathogens, Chlamydia trachomatis (Chlamydial Infection; Chlamydial Infection of the Genital Tract) and Neisseria gonorrhoea are the frequent organisms.
iii) In older age, Escherichia coli and Pseudomonas species are responsible for most infections.
Microscopically, nonspecific interstitial congestion, edema and neutrophilic infiltrates occur in the early stage, with subsequent involvement of tubules. Severe cases may progress to generalized suppuration of the entire epididymis. Inflammation may extend to the testis via efferent ductules or local lymphatic channels. Scarring of the testis and epididymis may occur with resultant infertility. Leydig cells are less severely affected and sexual activity generally is not disturbed.