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Epididymitis and Orchitis

Background Knowledge 🧠

Definition

  • Epididymitis: Inflammation of the epididymis,Β the coiled tube at the back of the testicle.
  • Orchitis: Inflammation of one or both testicles.

Aetiology

  • Most commonly caused by bacterial infections including STIs like chlamydia and gonorrhoea.
  • Mumps virus: A common cause of viral orchitis.
  • Urinary tract infections or prostate infections can lead to epididymitis.
  • Use of the medication amiodarone.
  • Tuberculosis (rare cause).

Clinical Features πŸŒ‘️

Clinical Presentation

  • Testicular pain and tenderness, usually unilateral.
  • Redness and warmth in the scrotum.
  • Swollen, firm testicle.
  • Possible fever and chills.
  • Penile discharge.
  • Groin pain.

Investigations πŸ§ͺ

Investigations

  • Scrotal ultrasound: To assess inflammation and rule out testicular torsion.
  • Urine tests: To identify bacteria or other signs of disease.
  • STI screening: Swab test or urine test for gonorrhoea and chlamydia.
  • Blood tests: To assess for infection.

Management πŸ₯Ό

Management

  • Antibiotics: Specific to the causative bacteria.
  • Anti-inflammatory painkillers (e.g., ibuprofen).
  • Bed rest and scrotal elevation to reduce pain.
  • Ice packs for swelling.

Complications

  • Abscess formation in the scrotum.
  • Chronic epididymitis.
  • Reduced fertility.
  • Testicular atrophy.
  • Spread of infection.

Key Points

  • Epididymitis and orchitis are commonly caused by bacterial infections (STIs) and Mumps virus.
  • Patients often present with testicular pain and tenderness, scrotal redness, and a swollen, firm testicle.
  • Diagnosis is primarily obtained through assessing for infection (urine tests, STI screening) and excluding testicular torsion (scrotal ultrasound).
  • Management includes antibiotics (bacterial infection) and pain relief (analgesics, scrotal elevation).

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