Introduction.
Acute nonspecific deferentitis (AND) or inflammation of the vas deferens (VD),
known in English literature as acute nonspecific vasitis,
is poorly understood and not sufficiently addressed in the literature disease.
As shown by personal experience,
in contrast to the well-known post-vasectomy vasitis nodosa (resp.,
sperm granulomas VD),
the AND is unfamiliar to a wide circle of radiologists and practical urologists.
To prove the above stated it should be noted that in many domestic and foreign guides for radiology and urology the AND,
as a separate nosology,
are not considered (for example,
Russian National Manual of Urology by edited N.A.
Lopatkin,
2009; Emergency Radiology by edited B.
Marincek and R.F.
Dondelinger,
2007; Campbell-Walsh Urology 9th ed,
2007 and others).
Based on aetiology and pathogenesis of the AND,
it can be divided into primary and secondary forms.
Primary AND occurs very rarely,
in the literature there are only sporadic observations of the primary AND [1 - 7].
Primary AND proceeds as an inguinal funiculitis with sepsis caused by hematogenic pyogenic microflora.
In clinical practice significantly more common secondary AND,
which occurs in association with epididymo-orchitis or acute prostatitis at urogenital infections in sexually active patients [8].
Among the radiological methods of diagnosis AND have been applied ultrasound,
CT [6,7,9].
The main method of diagnosis AND is the high resolution ultrasound,
which allows us to examine the structure and vascularization of all the anatomical parts of the VD,
except pelvic division VD.
However,
in PubMed was found only one publication in ultrasonic diagnostics AND,
based on a retrospective analysis of 12 cases of AND [9].
In this connection,
this paper focuses on clinical and ultrasound diagnostic aspects the secondary AND.
The practical relevance of this study caused by the following reasons:
a) the AND is manifested syndrome “acute scrotum” in both children and adults and can be a reason for emergency hospitalization and temporary disability;
b) the AND has non-specific clinical and laboratory picture similar to other sharp urological and surgical diseases of the urinary tract and groin area,
as a consequence of the AND in a clinical study usually not recognized;
c) timely unrecognized AND usually ends obliteration VD.
Therefore the bilateral AND can lead to obstructive azoospermia,
which is one of the most common causes of male infertility;
d) timely unrecognized complication of the AND,
such as abscess VD,
for example,
during epididymectomy in a patient with acute destructive epididymitis,
may be the cause of re-extended surgical intervention,
namely orchifuniculectomy.
It can lead for additional physical and mental traumatization in patient.
The purpose of this study was to improve the quality of diagnosis AND using high-resolution ultrasound.
During the work consistently were solved the following tasks:
1) to study of normal ultrasound anatomy VD in the control group;
2) to study of clinical and ultrasound manifestations AND in adult patients;
3) to evaluate of the comparative efficacy of clinical-laboratory and ultrasonic diagnostic methods AND.