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Epididymitis

David B. McCaleb, MD and Holly L. Baab, MD Reviewed 06/2018
 


BASICS

  • Acute epididymitis: scrotal pain for <6 weeks

  • Chronic epididymitis: scrotal pain for ≥3 months

DESCRIPTION

  • Inflammation (infectious or noninfectious) of epididymis resulting in scrotal pain and...

DIAGNOSIS

HISTORY

  • Gradual onset of scrotal pain, sometimes radiating to the groin region over 1 to 2 days

  • Urethral discharge or symptoms of UTI, such as frequency of urination, dysuria, cloudy urine, or...

TREATMENT

GENERAL MEASURES

  • Bed rest or restriction on activity

  • Scrotal elevation, athletic scrotal supporter

  • Ice pack wrapped in towel

  • Avoid constipation.

  • Spermatic cord block with local anesthesia in seve...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Routine follow-up in 1 week. Follow up within 72 hours if symptoms fail to improve with treatment for reevaluation of diagnosis and therapy (3)[...

REFERENCES

1
1 Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician.  2009;79(7):583–587. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 McConaghy JR, Pa...

ADDITIONAL READING

  • Somekh E, Gorenstein A, Serour F. Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol.  2004;171(1):391–394. {L-End} {L-End} [View Abstract on OvidMed...

CODES

ICD10

  • N45.1 Epididymitis

  • N45.3 Epididymo-orchitis

  • N45.4 Abscess of epididymis or testis

  • N45.2 Orchitis

ICD9

  • 604.90 Orchitis and epididymitis, unspecified

  • 604.99 Other orchitis, epididymitis, and epidid...

CLINICAL PEARLS

  • With epididymitis, the pain is gradual in onset, and the tenderness is mostly posterior to the testis. With testicular torsion, the symptoms are quite rapid in onset, the testis will b...

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