Epididymitis Questions & Answers

Updated: Aug 05, 2020
  • Author: Christina B Ching, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Questions & Answers

Overview

What is epididymitis and which true urologic emergency must it be differentiated from?

What are the complications associated with acute epididymitis and bacterial orchitis?

What are the complications associated with mumps orchitis relative to epididymitis?

What should patients be educated about regarding epididymitis?

Which history findings are consistent with acute epididymitis and orchitis?

Which history findings are consistent with chronic epididymitis?

Which history findings are consistent with mumps orchitis/epididymitis?

Which physical findings are associated with acute epididymitis and can distinguish it from testicular torsion?

Which findings are associated with orchitis/epididymitis?

Which lab studies are indicated in the workup of epididymitis?

Which imaging studies are used to evaluate structural abnormalities and help distinguish acute epididymitis from testicular torsion?

Which diagnostic procedures may be indicated in the evaluation of epididymitis?

Which medications are used in the treatment of epididymitis?

Which supportive measures are used in the treatment of acute epididymitis and orchitis?

When is surgery indicated in the treatment of epididymitis and which surgical interventions are used?

What is the anatomy of the epididymis?

What causes epididymitis?

What causes epididymo-orchitis/epididymitis?

What are the most common causes of acute epididymo-orchitis/epididymitis in children and men older than 35 years?

What is the most common cause of acute epididymo-orchitis/epididymitis in sexually active men younger than 35 years and which pathogens cause infections in this population?

How common is TB epididymitis?

Can epididymo-orchitis/epididymitis be caused by cancer treatment?

What is the most common cause of pediatric epididymitis?

Which rare infections have been implicated in epididymitis?

What is the role of vasectomy in epididymitis?

Can acute epididymo-orchitis/epididymitis be related to surgical procedures or physical activity?

What is the etiology of epididymitis in children?

How common is acute epididymo-orchitis/epididymitis in the setting of Behcet syndrome or Henoch-Schönlein purpura?

What is amiodarone epididymitis and how does it occur?

What is the role of sarcoidosis in the etiology of epididymitis?

What is the etiology of chronic epididymitis?

What are the causes of acute orchitis relative to epididymitis?

How common is orchitis/epididymitis in postpubertal boys with mumps?

What is the incidence of epididymitis?

How common is epididymitis in men ages 18-50 years?

What are the age-related demographics of acute epididymitis?

What are the age-related demographics of urogenital abnormalities in epididymitis?

How common is mumps orchitis in postpubertal boys with mumps?

Which factors have been associated with severity of epididymitis in Japanese men?

What is the prognosis of epididymitis?

What is the risk of acquiring and transmitting HIV in patients with epididymitis?

Presentation

Which history findings are associated with acute epididymitis and orchitis?

Which history findings are associated with chronic epididymitis?

Which history findings are associated with mumps orchitis relative to epididymitis?

Which symptoms may be described by patients with sexually transmitted epididymitis?

What recent history is more common in older patients with epididymitis?

Where do tenderness and induration occur initially in epididymitis, and how does the infection typically spread?

How are physical exam findings for the Prehn sign and cremasteric reflex used to distinguish acute epididymitis from testicular torsion?

Which signs of epididymitis may be observed in the physical exam?

What are the physical exam findings in epididymitis due to TB?

Which urogenital tract anomalies may be associated with epididymitis in children?

What are the physical exam findings of orchitis relative to epididymitis?

DDX

Which conditions should be considered in the differential diagnosis of epididymitis?

What are the differential diagnoses for Epididymitis?

Workup

Which lab studies are indicated in epididymitis?

Which lab study is indicated in mumps orchitis relative to epididymitis?

Are amiodarone plasma levels used in the diagnosis of amiodarone-induced epididymitis?

Which imaging study can be used to distinguish acute epididymitis from testicular torsion?

Which imaging studies are used in the workup of epididymitis in children?

Which imaging studies are used in the workup of TB epididymitis?

Which procedure may be indicated to evaluate structural abnormalities in children with epididymitis?

When is scrotal exploration or aspiration indicated in the workup of epididymitis?

What are the lab findings in acute epididymitis and nonviral orchitis?

Which lab studies are used in the workup of gonorrheal and chlamydial infections in epididymitis?

When is blood culture testing indicated in epididymitis?

Which studies are used to evaluate for underlying congenital anomalies in pediatric patients with epididymitis?

When is color Doppler ultrasonography indicated in the workup of epididymitis and what are its sensitivity and specificity?

How is chronic epididymitis characterized on color Doppler ultrasonography?

Which imaging study is used to detect testicular infarction in the workup of epididymitis?

Which conditions can cause false-positive results in radionuclide scanning for epididymitis?

What is the sensitivity and specificity of radionuclide scanning in epididymitis?

How are acute epididymitis and testicular torsion characterized in radionuclide scanning?

What is the indication for radionuclide scintigraphy in the workup of epididymitis?

Treatment

What is the treatment for chronic epididymitis?

What is the treatment for epididymitis secondary to Chlamydia trachomatis or Neisseria gonorrhoeae?

Which antibiotic is preferred in the treatment of epididymitis due to an enteric organism?

When is antibiotic therapy indicated in prepubertal boys or infants with epididymitis?

When is immediate consultation with a urologist indicated in the setting of epididymitis?

When is surgical intervention indicated in the treatment of epididymitis?

What are the CDC guidelines for treatment of acute epididymitis due to sexually transmitted infection?

What are the CDC treatment guidelines for acute epididymitis due to enteric organisms?

What are the mainstays of supportive therapy for acute epididymitis and orchitis?

How effective is epididymectomy in the treatment of epididymitis?

Medications

Which medications in the drug class Antituberculous drugs are used in the treatment of Epididymitis?

Which medications in the drug class Antibiotics are used in the treatment of Epididymitis?