Epididymitis

Question 1

What is epididymo-orchitis?

Answer 1

Inflammation of the epididymis and testicle - normally due to infection

Question 2

What is the route of sperm from the testicles?

Answer 2

Released from the testicle into the head of the epididymis. Then into the body then tail. It is stored in the epididymis to mature before being released into the vas defernes (sperm duct)

Question 3

What are the main causative organsims of epidiymo-orchitis?

Answer 3

Escherichia coli (e.coli)
Chlamydia trachomatis
Neisseria gonorrhoea
Mumps

Question 4

How does epididymo-orchitis present?

Answer 4

Gradual onset over mins to hours of unilateral

• testicular pain
• dragging or heavy sensation
• swelling or testicle and epididymis
• urethral discharge (think of STIs)
• systemic symptoms such as sepsis

Question 5

What investigations can be done to help diagnose epidiymo-orchitis?

Answer 5

Urine microscopy and culture
Chlamydia and gonorrhoea testing
Saliva swab - testing for mumps
Ultrasound - assessing for torsion or tumours

Question 6

How is epipidymo-orchitis managed?

Answer 6

Analgesia
Antibiotics - e.g. ofloxacin (broad spectrum)
If suggestive of STIs, refer to GUM clinic for treatment
Admit to hospital if any signs of sepsis.

Question 7

What are some complications for epididymo-orchitis?

Answer 7

Chronic pain
Chronic epididymitis
Testicular atrophy
Sub fertility or infertility
Scrotal abscess