Sunday, September 28, 2008

Testis and Epididymis: Specific Inflammations -Tuberculosis

Tuberculosis almost always begins in the epididymis and may spread to the testis.
Tuberculosis of testis is usually unilateral and may occur at any age.
They are commonly associated with the tuberculosis of lungs and genitourinary tract.
Discrete tubercles in the testis may be seen in generalized military tuberculosis.
Commonly earliest lesion is seen as an area of granuloma with caseous necrosis in the globus minor due to retrograde infection via vas deferens from seminal vesicle.
Blood-borne infection commences on the globus major.
This lesion usually regresses and becomes calcified.
Progressive lesion shows involvement of the entire epididymis.
Tunica vaginalis serves as a barrier against extension into the testis. It is often seen that there is complete destruction of the epididymis with no invasion of the testis.
Clinically, a firm often painless mass is felt behind the testis.
In 30% cases secondary hydrocele may be present.