Epidimytits and orchitis

Question 1

Define Epidimytits and orchitis

Answer 1

Infection of the Epididmys (thats the area that overlaps the cord linked to testicule)
associated with STI, UTI
epididymo-orchitis is when there is concurrent testes infection -
Usually unilateral
common cause of mass in testicule-but nothing to do with cancer

Question 2

Aetiology and risk factors of Epidimytits and orchitis

Answer 2

Mainly infectious causes-chlamydia trochamotis, Neisserissa ghonnorhoae, rarer-Mycoplasma genitalium, e coli
Older patient tends to be not STI related

Risk factors
often younger patients
Unprotected sex
Bladder outflow obstruction
Immunosupression

Question 3

Epidiemology of Epidimytits and orchitis

Answer 3

Most common cause of scrotal pain in Europe
600 000 cases per year
More common in middle aged young men (20-39)

Question 4

Signs and Sx of Epidimytits and orchitis

Answer 4

Unilateral pain and swelling around the test, over a few days (unlike torsion-hours)

Tenderness
Hot, red,
Palpable mass (people worry about cancer-fever is difference )

Sx of UTI

Question 5

Investigations of Epidimytits and orchitis

Answer 5

Urethral Swab culture-should be positif

Urine dipstick and MSU-WBC, growth of organism if UTI origin

NAAT test for chalydia, gnorrhoae and mycoplasma

Question 6

Management of Epidimytits and orchitis

Answer 6

Sx treatment-rest and analgesia

Abx given before results from cultures come back-broad spectrum
can be adjusted after cultures if needed
recommend ceftriaxone, doxycycline

Question 7

Complications of Epidimytits and orchitis

Answer 7

Low risk of abscesses if untreated

rare-testicular ischemia, due to cord being part of inflam

long term, if not treated, scarring can cause obstruction

Question 8

Prognosis of Epidimytits and orchitis

Answer 8

Usually fine on own, and even faster with Abx
care-rapid improvement can lead to reduced adherence

Complications are rare