EPIDIDYMITIS

Introduction: Epididymitis is an infection of the epididymis, which usually spreads from an infected urethra, bladder, or prostate. In prepubertal males, older men, and homosexual men, the predominant causal organism is Escherichia coli, although in older men, the condition may also be a result of urinary obstruction. In sexually active men aged 35 years and younger, the pathogens are usually related to bacteria associated with sexually transmitted diseases (STDs) such as, Chlamydia trachomatis, Neisseria gonorrhoeae.

Clinical Manifestations: Often slowly develops over 1 to 2 days, beginning with a low-grade fever, chills, and heaviness in the affected testicle. Unilateral pain and soreness in the inguinal canal along the course of the vas deferens. Pain and swelling in the scrotum and groin. There may be discharge from the urethra, blood in the semen, pus (pyuria) and bacteria (bacteriuria) in the urine, and pain during intercourse and ejaculation. Urinary frequency, urgency, or dysuria, and testicular pain aggravated by bowel movement.

Medical Management: If epididymitis is associated with an STD, the patient’s partner should also receive antimicrobial therapy. If seen within first 24 hours after onset of pain, patient’s spermatic cord may be infiltrated with a local anesthetic agent for relief. Supportive interventions include reduction in physical activity, scrotal support and elevation, ice packs, antiinflammatory agents, analgesics, including nerve blocks, and sitz baths. Observe for abscess formation. Epididymectomy (excision of the epididymis from the testes) may be performed for patients who have recurrent, refractory, incapacitating episodes of this infection.

RELATED;

1.  MEDICINE AND SURGERY

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