Epididymitis

Epididymitis
Other namesInflammation of the epididymis[1]
Acute epididymitis with abundant fibrinopurulent exudate in the tubules.
Pronunciation
SpecialtyUrology, infectious disease
SymptomsPain in the back of the testicle, swelling of the testicle, burning with urination, frequent urination[1]
ComplicationsInfertility, chronic pain[1]
Usual onsetOver a day or two[1]
TypesAcute (< 6 weeks), chronic (>12 weeks)[1]
CausesGonorrhea, chlamydia, enteric bacteria, reflux of urine[1]
Diagnostic methodBased on symptoms, ultrasound[1]
Differential diagnosisTesticular torsion, inguinal hernia, testicular cancer, orchitis[1][2]
TreatmentPain medications, antibiotics, elevation[1]
MedicationNSAIDs, ceftriaxone and doxycycline, ofloxacin[1]
Frequency600,000 per year (age 15-35, US)[2]

Epididymitis is a medical condition characterized by inflammation of the epididymis, a curved structure at the back of the testicle.[1] Onset of pain is typically over a day or two.[1] The pain may improve with raising the testicle.[1] Other symptoms may include swelling of the testicle, burning with urination, or frequent urination.[1] Inflammation of the testicle is commonly also present.[1]

In those who are young and sexually active, gonorrhea and chlamydia are frequently the underlying cause.[1] In older males and men who practice insertive anal sex, enteric bacteria are a common cause.[1] Diagnosis is typically based on symptoms.[1] Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer.[1] Ultrasound can be useful if the diagnosis is unclear.[1]

Treatment may include pain medications, NSAIDs, and elevation.[1] Recommended antibiotics in those who are young and sexually active are ceftriaxone and doxycycline.[1] Among those who are older, ofloxacin may be used.[1] Complications include infertility and chronic pain.[1] People aged 15 to 35 are most commonly affected, with about 600,000 people within this age group affected per year in the United States.[2]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x McConaghy, JR; Panchal, B (1 November 2016). "Epididymitis: An Overview". American Family Physician. 94 (9): 723–726. PMID 27929243.
  2. ^ a b c Trojian, TH; Lishnak, TS; Heiman, D (1 April 2009). "Epididymitis and orchitis: an overview". American Family Physician. 79 (7): 583–7. PMID 19378875.