Syphilis and Male Fertility: Testicular and Epididymal Damage

Syphilis Can Impair Male Reproductive Function

Untreated syphilis (caused by Treponema pallidum) can invade the genitourinary tract, leading to:

Testicular Involvement

• Gummatous orchitis: granulomatous inflammation destroying seminiferous tubules → impaired spermatogenesis → infertility.
• May mimic testicular tumor clinically.

Epididymal Involvement

• Epididymitis: inflammation, swelling, pain.
• Fibrosis and obstruction → obstructive azoospermia.

Other Manifestations

• Prostatitis, urethral strictures.
• Neurosyphilis can cause erectile dysfunction via autonomic damage.

Treatment and Prognosis

Penicillin G (parenteral) cures the infection at any stage, but structural damage (fibrosis, tubular loss) may be irreversible. Early treatment prevents reproductive sequelae.