ABSTRACT
100 cases of epididymitis were randomly chosen provided that they didn't receive antibiotics in the last 48 hours. We categorized the patients into two groups: those presenting with acute painfull scrotal swelling and fever into group A [5 6 patient] and those presenting with painless scrotal lumb of more than 3 months duration into group B [44 patients]. - Full clinical assessment including careful history taking and clinical examination was done to all patients. - Urine smears stained with Z.N. -staining were examined for alcohol and acid fast bacilli for all patients, and similar semen smears for group [B] patients were also done. - Urine culturing on Lowenstein-Jensen medium was done for all patients. - Semenogram was done for group [B] patients. - Semen of group [B] patients was cultured also on Lewenstein-Jensen medium. Abdominal ultrasound together with chest x-ray and plain x-ray abdomen had been performed to all cases. In Group [B] patients, I V.U was routinely done. It is clear that chronic epedidymitis is highly suspecious for T.B. It had been found that semen culturing or smearing by Z-N-Stain gave a better chance-than urine to isolate the T-B bacillus [semen smearing and culturing proved that 15.9% and 29% of patients respectively were positive for T.B. bacilli compared to 13.6% and 25% of patients in case of urine]. Semen parameters had been variably affected in tuberculous involvement of the epididymitis specially in bilateral cases [all bilateral cases and 3 out of 8 unilateral involvement were infertile]. In conclusion, T.B. bacillus is a relatively common causative organism in cases of chronic epididymitis [13% of total cases of epididymitis and 29% of chronic cases]