Epididymitis And Orchitis Flashcards
Define Epididymitis and Orchitis?
Inflammation of the epididymis or testes
What is the relation between Epididymitis and Orchitis?
60% of epididymitis is associated with orchitis
Most cases of orchitis are associated with epididymitis
What is the aetiology of Epididymitis and Orchitis?
Most cases are INFECTIVE in ORIGIN
1/3 are IDIOPATHIC
What are the bacterial causes of Epididymitis and Orchitis?
If < 35 yrs: Chlamydia and Gonococcus
If > 35 yrs: mainly coliforms (e.g. Enterobacter, Klebsilla)
Rare: TB, syphilis
What is the main viral cause of Epididymitis and Orchitis?
Mumps
What is the main Fungal cause of Epididymitis and Orchitis?
Candida if immunocompromised
What are the risk factors for Epididymitis and Orchitis?
Diabetes
RARE: vasculitis (e.g. Henock-Schonlein purpura)
What is the epidemiology of Epididymitis and Orchitis?
COMMON
Affects all age groups
Most commonly: 20-30 yrs
What are the presenting symptoms of Epididymitis and Orchitis?
Painful, swollen and tender testis or epididymis
Less acute onset than testicular torsion
Penile discharge
Ask about sexual history
What are the signs of Epididymitis and Orchitis?
Swollen and tender epididymis or testis
Scrotum may be erythematous and oedematous
Pyrexia
Walking will be painful
Eliciting a cremasteric reflex may be painful
What do you look for on urine for Epididymitis and Orchitis?
Dipstick
Early morning urine collections for MC&S
What bloods do you do for Epididymitis and Orchitis?
FBC - High WCC
High CRP
U&Es
What imaging do you do for Epididymitis and Orchitis?
Increased blood flow on duplex examination
What is the medical management plan for Epididymitis and Orchitis?
Antibiotics
What is the surgical management plan for Epididymitis and Orchitis?
Exploration of testicles if testicular torsion can’t be excluded clinically
Required if an abscess develops
