A Family Doctor's Tale - EPIDIDYMITIS OR ORCHITIS

DOC I HAVE EPIDIDYMITIS OR ORCHITIS

Epididymitis and orchitis are common infection in children especially after mumps infection and  injuries to the testicular region. They also occur in adults after contacting sexually transmitted diseases. There is pain and swelling in the testes.


Epididymitis and orchitis is acute bacterial or viral infection of the epididymis and testis.

The epididymis is the small organ on top of the testis.


The illness usually occurs in:
1.childhood, usually related to mumps infection

2.sexually active males

3.Epididymitis is more common than Orchitis

Bacterial infections:
1.Gonorrhea

2.Chlamydia

3.staphylococcus aureus

4.Streptococcus

5.Mycobacterium tuberculosis.

6.E.coli

Viral infections:
1.mumps in childhood

2.measles

Complications are:
1.Orchitis or infection of the testis following epididymitis

2.Abscess formation of the epididymis

3.Gangrene of the testis if blood flow is affected.

4.Inguinal lymphadenitis

Symptoms
1.Pain in scrotum

2.Ejaculation of blood

3.hematuria (blood in the urine)

4.Fever

Signs:
1.Scrotal swelling of testis or epididymis

2.Induration of scrotum wall

3.Tenderness of epididymis

4.Tenderness of the testis if orchitis is present

5.Mid stream urine for culture

6.Ultrasound of the testis and epididymis shows inflammation and enlargement of the testis and epididymis

Treatment of Acute Epididymitis and Orchitis
1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.

2.Fever and pain may be treated with paracetamol

3.Scrotal support helps to relieve the painful swollen testis

4.Ice packs for scrotum

5.Bed rest and Fluids

6.Surgical drainage if there is abscess formation.

Prognosis with appropriate treatment and antibiotics is generally good.

There is a risk of sterility and decreased male hormone production if treatment is inadequate.