Tuberculous epididymitis and fertility in North Jordan

OBJECTIVE: To describe the clinical characteristics of tuberculous epididymitis and its effect on male subfertility in a general hospital in the north of Jordan.

METHODS: A retrospective case study of the hospital records of patients with genitourinary tuberculosis managed at Princess Basma Teaching Hospital in Irbid, North Jordan during the period of 1994-2001.

RESULTS: Of the 16 patients with genitourinary tuberculosis, 9 were found to have tuberculous epididymitis. The mean age was 41.2 years. The main presentation was an insidious onset of painful scrotal swelling, mostly on the left side. Mean duration of symptoms was 10.6 weeks. Most patients had no history of previous tuberculosis and no Mycobacterium Tuberculosis in their urine. Six months of anti-tuberculous chemotherapy was effective, combined with surgery for scrotal abscesses. Although all patients recovered, the results on fertility are considerable.

CONCLUSION: Isolated tuberculous epididymitis is the most common form of genitourinary tuberculosis. A 6-month course of anti-tuberculous chemotherapy is effective in combination with surgery for large scrotal abscesses. The fertility outcome is of concern. Sperm retrieval and cryopreservation have to be considered for potential intra-cytoplasmic sperm injection.