Epididymitis and orchitis

Definition

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

Etiology

• 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 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

• 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

• 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.