Epididymitis and orchitis

Question 1

Define epididymitis

Answer 1

It is the inflammation of the epididymis

Question 2

Define orchitis

Answer 2

It is the inflammation of the testes

Question 3

What are the risk factors for epididymitis and orchitis?

Answer 3

1. Unprotected sexual intercourse
2. Bladder outflow obstruction
3. Instrumentation of urinary tract

Question 4

What are the causes of epididymitis and orchitis?

Answer 4

Mostly bacterial
Younger patients = Chlamydia trachomatis
Older patients = Enterobacter (enteric pathogens)

Question 5

What is the epidemiology of epididymitis and orchitis?

Answer 5

Most commonly between ages of 20-39yrs

Question 6

What are the presenting symptoms of epididymitis and orchitis?

Answer 6

1. Painful/tender/swollen testes/epididymis
2. Dysuria
3. Sweats or fever

Question 7

What are the signs of epididymitis and orchitis on physical examination?

Answer 7

1. Swollen/tender testes/epididymis
2. Scrotum may be erythematous
3. Pyrexia
4. Walking may be painful
5. Cremasteric reflex may be painful

Question 8

What are the appropriate investigations for epididymitis/orchitis?

Answer 8

1. Urine dipstick and MCS
2. Bloods - WBC (high), CRP (high)
3. Ultrasound (duplex)

Question 9

What is the management for epididymitis/orchitis?

Answer 9

1. Antibiotics
2. Analgesia
3. Abscess drainage if needed

Question 10

What are the complications for epididymitis/orchitis?

Answer 10

1. Abscess
2. Fertility issues
3. Chronic pain
4. Testicular atrophy/obstruction

Question 11

What is the prognosis for epididymitis/orchitis?

Answer 11

1. Rapid recovery with treatment

2. May lead to more serious issues (testicular atrophy and fertility issues)