Epididymitis Flashcards
Define epididymitis.
Epididymitis is an inflammation of the epididymis characterised by scrotal pain and swelling of less than 6 weeks’ duration. It may be associated with irritative lower urinary tract symptoms, urethral discharge, and fever. It is usually unilateral.
Explain the aetiology/risk factors of epididymitis.
Unprotected sexual intercourse
Bladder outflow obstruction
Instrumentation of urinary tract
Summarise the epidemiology of epididymitis.
The most common cause of acute scrotal pain is epididymitis. In the UK, the reported incidence was 2.45 cases per 1000 men between 2003 and 2008.
Recognise the presenting symptoms of epididymitis. Recognise the signs of epididymitis on physical examination.
Presence of risk factors
Age >19 years
Unilateral scrotal pain and swelling of gradual onset
Symptoms <6 weeks’ duration
Tenderness
Hot, erythematous, swollen hemiscrotum
Identify appropriate investigations for epididymitis and interpret the results.
Gram stain of urethral secretions
Urine dipstick test
Urine microscopy
Urine culture
Nucleic acid amplification test (NAAT) of urethral secretions or first-void urine for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium
Culture of urethral secretions
Generate a management plan for epididymitis.
Antibiotic therapy
Identify the possible complications of epididymitis and its management.
Abscess formation
Testicular ischaemia/infarction
Epididymal obstruction
Chronic pain following epididymitis
Male factor infertility
Summarise the prognosis for patients with epididymitis.
In men with infectious acute epididymitis, symptoms usually resolve rapidly following the initiation of appropriate antibiotic therapy. Inadequately treated infectious epididymitis, particularly sexually transmitted infection, can in rare cases lead to epididymal obstruction or testicular atrophy and subsequent infertility problems.
