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Epididymitis

Jarrett Keller Sell, MD FAAFP AAHIVS and Michael T. Partin, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Inflammation (infectious or noninfectious) of the epididymis resulting in scrotal pain and swelling, induration of the posterior epididymis, involvement of the adjacent testicle, 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 urinary frequency, dysuria, cloudy urine, or hema...

TREATMENT

GENERAL MEASURES

  • Bed rest or restriction of activity

  • Scrotal elevation, athletic scrotal supporter

  • Ice pack wrapped in towel

  • Avoid constipation

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

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.

  • Swel...

REFERENCES

1
Trojian  TH, Lishnak  TS, Heiman  D. Epididymitis and orchitis: an overview. Am Fam Physician.  2009;79(7):583–587. [View Abstract on OvidMedline] ...

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. [View Abstract on Ov...

CODES

ICD10

  • N45.1 Epididymitis

  • N45.2 Orchitis

  • N45.3 Epididymo-orchitis

  • N45.4 Abscess of epididymis or testis

  • N45 Orchitis and epididymitis

  • A54.23 Gonococcal infection of other male genital organs

  • A56.19 Othe...

CLINICAL PEARLS

  • With epididymitis, 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 be hi...

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