Idiopathic scrotal oedema usually presents in childhood with bilateral oedema and bruising over the scrotal skin. The testes should not be tender on examination. Taking history Onset: insidious presentation suggests infection. [bmj.com]

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]

Small surrounding hydrocele is present. View larger version (168K) Fig. 11B. —30-year-old man with tuberculosis epididymo-orchitis. [ajronline.org]

This presentation helps differentiate epididymitis and orchitis from testicular torsion, which is a surgical emergency. [aafp.org]

• Scrotal Pain

  Gradual onset of mild to moderate testicular or scrotal pain, usually unilateral Progressive scrotal swelling Dysuria (30%): Recent UTI History of abnormal bladder funct... [5minuteconsult.com]

  Epididymo-orchitis is the commonest cause of acute scrotal pain and refers to inflammation of the epididymis and testis. [bmj.com]

  pain and swelling;, which develops over several days and radiates to the ipsilateral flank Positive Prehn sign: reduced pain when the affected hemiscrotum is elevated Scrotal skin overlying the epididymis may appear red, shiny, and edematous. [amboss.com]

  These glands are very sensitive and even a minor injury can cause pain or discomfort. Many types of testicular or scrotal pain need medical attention. [wgurology.com]

  Among these cases, epididymitis or epididymo-orchitis were diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis. [trdizin.gov.tr]

• 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]

  Testicular pain Many testicular and scrotal conditions can cause testicular pain. Other conditions, like kidney and ureteral stones, infections, and inguinal hernias can also cause pain that can be felt in or around the testicles and scrotum. [beaumont.org]

  The testicular pain and swelling will last much longer. Untreated infection is more likely to lead to complications such as chronic testicular pain an abscess rarely testicular atrophy and loss of fertility More information www.bashh.org.uk [sexualhealthkingston.co.uk]

  Overview of Testicular Pain Testicular pain, or any pain in one or both sides of the scrotum (sac that holds the testicles), should be taken seriously. Pain in the scrotum can occur in males of any age, including newborns. [wgurology.com]

  If you do not get treatment, the testicular pain and swelling will last much longer. An untreated infection is more likely to lead to complications such as long-term testicular pain or an abscess. [sexualwellbeing.ie]

• Swelling of the Scrotum

  A man’s two testicles sit inside the scrotum. One epididymis sits behind each testicle. Epididymitis is inflammation (swelling and irritation) of this tube. Orchitis occurs when the inflammation spreads to the testicle. [veteranshealthlibrary.va.gov]

  Epididymo-orchitis is a condition characterised by pain and swelling in the scrotum. It is caused by infection and inflammation in the epididymis and/or testicle. Epididymitis means inflammation of the epididymis. [sexualhealthdorset.org]

  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]

  Symptoms Symptoms of epididymitis and orchitis can include: Pain, swelling and tenderness in your scrotum. Only one side of the scrotum is affected. Pain that at first is most intense at the back of one testicle. [drugs.com]

  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]

• Testicular Mass

  normal cremasteric reflex Testicular masses or swollen testicles with hypoechoic and hypervascular areas Testicular torsion Acute onset of pain, usually severe High-riding transversely oriented testis; abnormal cremasteric reflex; pain with testicular [aafp.org]

  At USG, testicular tumors usually appear as discrete masses, or the entire testis may be involved. They may be diffusely or heterogeneously hypoechoic. [wajradiology.org]

• Epididymal Swelling

  Chronic epididymitis: The pain occurs only in the scrotal contents, and is less severe and more localized than acute epididymitis. Swelling, tenderness, redness and warmth of the skin do not occur. [brandywineuc.com]

  Acute epididymitis typically presents with symptoms of epididymal swelling, induration, and exquisite tenderness to palpation and may also be accompanied by fever, chills, or dysuria [1]. [hindawi.com]

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 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 and prognosis The vast majority of patients are managed with simple analgesia and oral antibiotics. [radiopaedia.org]

In children, infection is less common an etiology. [emedicine.medscape.com]

Microbial etiology and predisposing factors in acute epididymitisFootnote 3 Age group Etiology and predisposing factors Prepubertal children Usual etiology: coliforms, P. aeruginosa Unusual etiology: hematogenous spread from primary infected site Predisposing [canada.ca]

Definition, Classification and Etiology of Epididymitis Acute or chronic inflammation of the epididymis of various etiologies: Bacterial epididymitis Epididymitis secondary to urinary tract infection : E. coli, Proteus, Klebsiella, Pseudomonas, Staphylococci [urology-textbook.com]

The authors conclude that further studies on the epidemiology, etiology and pathogenesis of this condition are needed. References [canada.ca]

[…] if symptoms don’t settle with empiric treatment Useful resources: British Association of Sexual Health and HIV guidelines Hepatitis C Screening National Clinical Guideline British Association of Sexual Health and HIV statement on partner notification Epidemiological [hse.ie]

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]

Summary Epidemiology The overall prevalence and incidence of these conditions is difficult to estimate but autosomal recessive malignant osteopetrosis (ARO; see this term) has an incidence of 1/ 250,000 births, and autosomal dominant osteopetrosis (ADO [orpha.net]

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]

1 – The structure of the testis and epididymis Classically, these two conditions are thought to occur together (termed epididymo-orchitis), however most cases are solely epididymitis, whilst a sole orchitis is very rare and is mostly of viral origin Pathophysiology [teachmesurgery.com]

Pathophysiology Ascending infection via vas deferens from prostatic Urethra IV. [fpnotebook.com]

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]

Centers for Disease Control and prevention (CDC). Update: mumps outbreak – New York and New Jersey, June 2009-January 2010. MMWR Morb Mortal Wkly Rep. 2010;59(5):125–129. Centers for Disease Control and Prevention (CDC). [cambridge.org]

Treatment of Acute Epididymitis The goals are to cure the infection, prevent transmission of the infection to others, and prevent infertility or chronic pain. [innerbody.com]

Prevention To help reduce your chance of orchitis: Get vaccinated with the MMR vaccine. Practice safe sex, including wearing a latex condom to prevent STIs. Get prompt treatment for any infections. [winchesterhospital.org]

There also is no recommended method to prevent varicoceles, hydroceles, or testicular torsion. Epididymitis can sometimes be prevented by practicing safe sex and avoiding heavy lifting or straining with a full bladder. [webmd.com]

How do I prevent epididymo-orchitis? When you are sexually active, the best way to prevent epididymo-orchitis is to use condoms for oral, vaginal, and anal sex. [myhealth.alberta.ca]