[The role of surgery in acute epididymitis]

One third of the acute épididymitis (A.E.) admitted in the Military Hospital in Marseilles have been operated, i.e. 33 cases; out of them the last 12 cases have been systematically monitored by ultrasonography. Twice out of three times, clinical picture suggested a possible twisting that led to an emergency surgical exploration. Interest of ultrasonography of the scrotum is underlined as far as diagnosis is concerned but also in monitoring A.E. Indeed, despite medical treatment (antibiotics + anti-inflammatory drugs), it is possible that some A.E. are evolving either to abscess or to their "vascular" form; The ultimate form of the acute epididymo-orchitis is necrosis of the testis. This is due to, or amplified by, vascular compression linked up with edema. Surgical intervention has therefore to investigate by inguinal path the entire spermatic cord and the épididymis-testis system, and to apply the "decompression technique" requested.