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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.

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