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 findings are associated with orchitis/epididymitis?
Which lab studies are indicated in the workup of epididymitis?
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?
What is the anatomy of the epididymis?
What causes epididymo-orchitis/epididymitis?
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?
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?
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?
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 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?
-
Cross-section illustration of a testicle and epididymis. A: Caput or head of the epididymis. B: Corpus or body of the epididymis. C: Cauda or tail of the epididymis. D: Vas deferens. E: Testicle. Illustration by David Schumick, BS, CMI. Reprinted with the permission of the Cleveland Clinic Center for Medical Art and Photography © 2009. All Rights Reserved.
-
Color Doppler sonogram of the left epididymis in a patient with acute epididymitis. The image demonstrates increased blood flow in the epididymis resulting from the active inflammation.
-
Scrotal sonogram demonstrating the presence of a hydrocele and an enlarged epididymis in a patient with epididymitis. The echogenic white area is the normal testicle surrounded by the hydrocele.
-
Scrotal sonogram showing the testes adjacent to the inflamed epididymis with a reactive hydrocele.