(Infection)

Overview

• Epididymitis → inflammation of the epididymis (cord that connects testis with ductus deferens), usually as a result of an infection
• May be due to a UTI (most common cause among older men & children, E.coli most common pathogen) or an STI (more common in young males <35, chlamydia trachomitis and Neisseria gonorrhoeae **are most common)
• Risk Factors → unprotected sexual intercourse, bladder outflow obstruction, UTIs, immunosuppression, vasculitis, mumps
  • Mumps (ORCHITIS) = fever, malaise, muscular pain, parotitis (earache or pain on eating). Typically prevented via MMR vaccine. Notifiable disease. Complications include orchitis and pancreatitis.

Making Diagnosis

Clinical Features:

• Unilateral scrotal pain and swelling, develops over several days and radiates to the ipsilateral flank
• Tenderness along posterior testis
• Positive Prehn Sign → pain relief on elevation of the testes (-ve in Testicular Torsion)
• Hot, erythematous, swollen hemiscrotum
• Low grade fever
• Hx of..
  • Symptoms of lower UTI → dysuria, frequency, urgency
  • Symptoms of STI → penile discharge

<aside> 💡 Testicular Torsion ⇒ age <20 yrs, severe pain, more acute onset, -ve prehn sign

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