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Orchitis and Epididymitis

Epididymoorchitis


Presentation

  • Clinical presentation Epididymo-orchitis is a condition that presents with pain in the scrotum, often accompanied by swelling. It needs to be differentiated from torsion of the testis by scrotal ultrasound scan.[ww2.health.wa.gov.au]
  • Better understand how problems present differently in infants, children, and adolescents with age-specific diagnoses.[books.google.com]
  • This presentation helps differentiate epididymitis and orchitis from testicular torsion, which is a surgical emergency.[aafp.org]
Costovertebral Angle Tenderness
  • It is important to check for costovertebral angle tenderness, a sign of concomitant pyelonephritis, and for signs of cystitis by palpating the suprapubic region.[aafp.org]
Testicular Pain
  • If it is left untreated, it could lead to chronic epididymo-orchitis, where persistent testicular inflammation leads to recurring testicular pain. It can also lead to testicular shrinkage or testicular abscess (pus collection within the testicle).[leedssexualhealth.com]
  • It’s thought to be part of a health issue called orchalgia (chronic testicular pain). Epididymo-orchitis is the sudden swelling of both the epididymis and the teste.[urologyhealth.org]
  • Testicular torsion should be ruled out in all cases of new-onset testicular pain. Epididymitis usually due to STD in sexually active men Epididymitis usually due to colifor... Brenner JS, Ojo A. Causes of scrotal pain in children and adolescents.[5minuteconsult.com]
  • If you have testicular pain, you should contact your doctor right away. And if you experience a sudden onset of testicular pain, you should seek emergency medical care to rule out serious conditions like testicular torsion.[beaumont.org]
Scrotal Pain
  • Causes of scrotal pain in children and adolescents. UpToDate. Available at www.uptodate.com . Accessed on January 30, 2013. Ching CB, Sabanegh ES.[5minuteconsult.com]
  • If you have any questions, to schedule a consultation or if you need a second opinion , please contact us or call 1-(646) 663-5747 Alex Shteynshlyuger MD is an experienced urologist who treats men with testicular and scrotal pain, epididymitis and epididymo-orchitis[newyorkurologyspecialists.com]
  • The patient will develop unilateral (one-sided) scrotal pain, in associated with testicular swelling, fever , discharge from the penis, pain with urination and pain with sexual intercourse.[myvmc.com]
  • Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever.[aafp.org]
Swelling of the Scrotum
  • Call your doctor immediately if you develop pain, tenderness or swelling in your scrotum, especially if these symptoms develop rapidly over a few hours.[health.am]
  • This is pain and swelling of the scrotum (sac round balls). It is usually caused by an infection in the epididymis, testicle or tubes. What might I notice? Pain, redness or swelling in the scrotum.[sexualhealth.cht.nhs.uk]
  • It can affect one or both testicles, and it can cause swelling in the scrotum and groin area. Hydrocele is not usually painful or harmful, and it may not need treatment. However, any swelling in the scrotum should be evaluated by a doctor.[beaumont.org]
  • Diagnosis and Treatment In acute epididymitis, the physical examination shows tenderness and swelling of the scrotum, discharge from the penis, enlarged groin lymph nodes , and fever.[innerbody.com]
  • When to see a doctor If you have pain or swelling in your scrotum, especially if the pain occurs suddenly, see your doctor right away. A number of conditions can cause testicle pain, and some require immediate treatment.[mayoclinic.org]
Testicular Mass
  • Follow-up Follow-up is recommended three to seven days after initial evaluation and initiation of treatment to evaluate for clinical improvement and for the presence of a testicular mass. 4 , 22 With treatment, pain typically improves within one to three[aafp.org]
  • In more than 50% patients with epididymo-orchitis, the resistive index is [10] The major clinical differential diagnoses of tuberculous epididymo-orchitis are testicular mass, testicular torsion and bacterial epididymo-orchitis.[wajradiology.org]
Epididymal Tenderness
  • tenderness that progresses to testicular swelling and tenderness; normal cremasteric reflex; pain relief with testicular elevation (Prehn sign) Enlarged, thickened epididymis with increased blood flow on color Doppler Orchitis Abrupt onset of testicular[aafp.org]

Workup

  • Surgical indications present Older age group if it is the only way to ensure appropriate workup: Many will have underlying urologic pathology. Systemically ill, fev... Testicular torsion should be ruled out in all cases of new-onset testicular pain.[5minuteconsult.com]
  • Diagnostic Workup for Testicular Torsion The main diagnostic tool for the evaluation of a suspected case of testicular torsion is history and physical examination.[lecturio.com]

Treatment

  • Treatment Treatment for a sexually transmitted cause should be for at least two weeks.[ww2.health.wa.gov.au]
  • Treatment includes medicine to get rid of the infection. It also includes medicine and other methods to relieve symptoms. Possible treatments Antibiotics. Acute epididymitis is most often treated with oral antibiotics.[saintlukeshealthsystem.org]
  • Treatment includes medication to get rid of the infection. It also includes medication and other methods to relieve symptoms. Possible treatments Antibiotics. Acute epididymitis is most often treated with oral antibiotics.[mountnittany.org]

Prognosis

  • With the development of the epididymis abscesses in severe cases, removal of the epididymis produce With timely treatment of acute process, a favorable prognosis. If there is no treatment or inadequate treatment, it can lead to infertility.[medusanews.com]
  • Prognosis With treatment, most cases of mild epididymitis and orchitis can be cured. There is usually no long-term effect on fertility, especially when only one side of the scrotum is involved.[health.am]
  • Treatment and prognosis The vast majority of patients are managed with simple analgesia and oral antibiotics.[radiopaedia.org]

Etiology

  • All providers of pediatric health care should understand the etiology and recognize the presenting signs and symptoms of epididymitis and orchitis, conditions that must be distinguished promptly in the emergency setting to avoid the risk of gonadal loss[pedsinreview.aappublications.org]
  • In patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome, fungal and viral etiologies, including cytomegalovirus, have been reported. 7 , 8 Noninfectious etiologies of epididymitis have been identified in numerous groups[aafp.org]
  • Etiology, manifestations, and therapy of acute epididymitis: prospective study of 50 cases. J Urol . 1979;121:750-754 PubMed Google Scholar 44. Pearson RC, Baumber CD, McGhie D, et al.[link.springer.com]

Epidemiology

  • Introduction Clinical definition inflammation of epididymis with symptoms of 6 weeks Epidemiology incidence 25 per 100,000 persons demographics men 18-35 years old risk factors sexual activity bladder outlet obstruction Etiology pathogens from sexually[medbullets.com]
  • C 12 Epidemiology In 2002, epididymitis or orchitis accounted for 1 in 144 outpatient visits (0.69 percent) in men 18 to 50 years of age. 1 There are approximately 600,000 cases of epididymitis per year in the United States, most of which occur in men[aafp.org]
  • Epidemiology Incidence (U.S.): 1 per 1000 Boys (up to age 13 years old) Prepubertal Epididymitis is much less common than Testicular Torsion in this age group Mean age of onset 11 years old Five year recurrence rate: 25% Men: Acute Epididymitis Ages 20[fpnotebook.com]
  • License: Flickr Commons Epidemiology of the Acute Scrotum in Adolescents The acute scrotum per our previous definition can be quite common in adolescents.[lecturio.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology Epididymitis is the most common cause of intrascrotal inflammation, 5 and retrograde ascent of pathogens is the usual route of infection.[aafp.org]
  • Table 2: Multifactorial comparisons Discussion The pathophysiology of epididymitis remains unclear. 4 In a study of 22 men with Escherichia coli or idiopathic acute epididymitis, and nine controls, urethrovasal reflux secondary to high voiding pressures[nature.com]
  • Pathophysiology Ascending infection via vas deferens from prostatic Urethra IV.[fpnotebook.com]

Prevention

  • Contact tracing is important to prevent reinfection. Always test for other STIs.[ww2.health.wa.gov.au]
  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • If you are treated for epididymo-orchitis, it is really important that your partner also gets treated before you have sex again to prevent reinfection.[leedssexualhealth.com]

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