INVITED REVIEW
Year : 2015  |  Volume : 17  |  Issue : 5  |  Page : 756-763

Epididymitis: revelations at the convergence of clinical and basic sciences


1 Department of Anatomy and Cell Biology; Justus-Liebig-University of Giessen, 35385 Giessen, Germany
2 Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University of Giessen, 35385 Giessen, Germany
3 Centre for Reproductive Health, azMIMR PHI Institute of Medical Research, Melbourne, Victoria, Australia

Correspondence Address:
Andreas Meinhardt
Department of Anatomy and Cell Biology; Justus-Liebig-University of Giessen, 35385 Giessen
Germany
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1008-682X.155770

Rights and Permissions

Acute epididymitis represents a common medical condition in the urological outpatient clinic. Mostly, epididymitis is caused by bacterial ascent through the urogenital tract, with pathogens originating either from sexually transmitted diseases or urinary tract infections. Although conservative antimicrobial therapy is possible in the majority of patients and is usually sufficient to eradicate the pathogen, studies have shown persistent oligozoospermia and azoospermia in up to 40% of these patients. Animal models of epididymitis are created to delineate the underlying reasons for this observation and the additional impairment of sperm function that is often associated with the disease. Accumulated data provide evidence of a differential expression of immune cells, immunoregulatory genes and pathogen-sensing molecules along the length of the epididymal duct. The evidence suggests that a tolerogenic environment exists in the caput epididymidis, but that inflammatory responses are most intense toward the cauda epididymidis. This is consistent with the need to provide protection for the neo-antigens of spermatozoa emerging from the testis, without compromising the ability to respond to ascending infections. However, severe inflammatory responses, particularly in the cauda, may lead to collateral damage to the structure and function of the epididymis. Convergence of the clinical observations with appropriate animal studies should lead to better understanding of the immunological environment throughout the epididymis, the parameters underlying susceptibility to epididymitis, and to therapeutic approaches that can mitigate epididymal damage and subsequent fertility problems.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2977    
    Printed39    
    Emailed0    
    PDF Downloaded447    
    Comments [Add]    
    Cited by others 2    

Recommend this journal