Acute Epididymo-Orchitis

Epidemiology of Acute Epididymo-Orchitis

• Most Common Organism – Chlamydia (Gonococcal epididymitis still prevalent)
• Develops in 18% of men suffering from Mumps , usually when parotid swelling is waning
• Mumps epididymitis in absence of parotiditis occurs in infants
• Other Causes – Enteroviruses , Brucellosis, LGV
• Escherichia coli is an important cause of nonspecific epididymitis and orchitis in children with congenital genitourinary abnormalities and in older men.
• Mycobacterium tuberculosis can cause tuberculosis of the epididymis and testes, characterized by granuloma formation.
• Pseudomonas sp. has been implicated as an important cause of nonspecific epididymitis and orchitis in older men.

Pathogenesis of Acute Epididymo-Orchitis

• May Follow Uretheral Instrumentation , prostatectomy

Signs & Symptoms (Clinical Features) of Acute Epididymo-Orchitis

• Scrotal Wall becomes red, edematous , shiny and become adherent to epididymis
• Orchitis without epididymitis is seen in SYPHILIS
• In differential diagnosis of epididymo-orchitis & torsion it is important that Elevation of testis in epididymo orchitis relieves pain
• Acute tuberculous epididymitis – thickened vas

Complication of Acute Epididymo-Orchitis

• The Main Complication is testicular atrophy which may cause infertility (if B/L) 

Diagnosis & Management of Acute Epididymo-Orchitis

• Doxycycline for Chlamydial infection, Plenty of fluids, scrotal support and analgesics