Epididymo-Orchitis Flashcards
1
Q
Aetiology of epididymitis / orchitis by age? 35?
A
-35 or penetrative anal intercourse: GI organisms (esp E. coli, other GNBs)
2
Q
RFx for epididymo orchitis?
A
- UTI
- Unprotected sex
- Instrumentation / IDC
- Reflux
- Increased pressure in prostatic urethra (straining, voiding, heavy lifting)
3
Q
Why may increased pressure in prostatic urethra precipitate epididymo-orchitis?
A
May cause reflux of urine along vas deferens –> sterile epididymitis
4
Q
What is Prehn’s sign?
A
Pain may be relieved with elevation of testicles in epididymitis but not in testicular torsion. Poor sensitivity (esp in children)
5
Q
CFx epididymo-orchitis?
A
- Worsening scrotal pain and swelling +/- radiation along cord to flank
- Scrotal erythema and tenderness
- Fever
- Irritative LUTS
- Purulent d/c
- Reactive hydrocele
6
Q
Ix in ?epididymo-orchitis?
A
- Urinalysis
- Urine MCS
- If d/c: MCS and PCR
- If dx uncertain ==> Doppler u/s to r/o testicular torsion
7
Q
Rx of epididymo-orchitis?
A
- R/o torsion
- ABx: GNB and STI coverage
- Scrotal support
- Bed rest
- Ice
- Analgesia
8
Q
ABx in epididymo-orchitis?
A
GNB cover:
- Trimethoprim / cephalexin / augmentin / norfloxacin x2/52
- Amp and gent
STI cover:
- Ceftriaxone 500mg IM OD x 3/7 &
- azithromycin 1g PO stat &
- Doxycycline 100mg BD x 2/52
9
Q
PEx findings in epididymo-orchitis?
A
- Swelling / tenderness
- Fever
- Hydrocele
