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Epididymitis

Last updated: October 22, 2020

Summary

Epididymitis is an inflammation of the epididymis that is commonly associated with genitourinary tract infections. The typical presentation involves a gradual onset of pain and swelling of the affected side of the scrotum as well as a positive Prehn sign. Epididymitis is a clinical diagnosis, but testicular torsion should be excluded by ultrasound because it has a similar presentation and is a surgical emergency. Treatment involves prompt empiric antibiotic therapy, scrotal elevation, and nonsteroidal anti‑inflammatory therapy to prevent abscess formation and possible infertility.

Etiology

Clinical features

Diagnostics

Primarily a clinical diagnosis

Differential diagnoses

Testicular torsion is the most important differential diagnosis of epididymitis and must be ruled out!

The differential diagnoses listed here are not exhaustive.

Treatment

Complications

We list the most important complications. The selection is not exhaustive.

References

  1. Ludwig M. Diagnosis and therapy of acute prostatitis, epididymitis and orchitis. Andrologia. 2008; 40 (2): p.76-80.
  2. Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: An overview. Am Fam Physician. 2009; 79 (7): p.583-587.