epididymitis Flashcards
what is epididymitis?
inflammation of epididymis
what is Orchitis?
inflammation of testicle
causes of epididymitis
Behcet’s disease Amiodarone Testis or epididymal tumor Acute Bacterial infection viral Granulomatous (TB)
Presentation of Epididymitis
Gradual onset vs abrupt onset
Urethral discharge and urethritis sx, if STD
Physical exam
Edematous tender testicle, epididymis, spermatic cord
+/- fever
Hydrocele
what is included in an evaluation of acute epididymititis?
clinical dx
Urine culture
STD susp. - order tests
+/- scrotal U/S w/doppler
Tx?
Scrotal support
Analgesia
Cold
antibiotics
What abx can you use?
If suspect STD: Ceftriaxone and Doxycycline Not suspecting STD: Levofloxacin Severe cases, IV abx If TB --> antituberculars empiric
When does acute become chronic epidiymititis
3 months or more
evaluation of chronic epididymitis
H & P
UA, Urine C&S, other cultures as indicated
Scrotal ultrasound w/ Doppler
CT (ie. stones)
Conservative tx for chronic epididy?
Analgesics, Pain clinic, Scrotal support, Modification of activities, Moist heat, Spermatic cord block, abx
Surgical options for chronic epididy?
Testicular denervation
Removal of sperm granuloma
If obstruction–> vasovasostomy or epididymectomy
If intermittent torsion –> orchiopexy
Inguinal orchiectomy
