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    Orchitis (Eng)

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    Ferzy Awwali Fadhila
    Epididymitis and orchitis are inflammations of the epididymis and testes, respectively, often caused by infection. Common causes include sexually transmitted infections in men ages 14-35 and E. coli in men under 14 or over 35. Symptoms include tenderness, swelling, and pain relieved by elevation. Diagnosis involves testing urine and urethral discharge. Treatment depends on the suspected cause but generally involves antibiotics. Complications can include hydrocele, abscess, or infertility, but with treatment pain usually improves within days and swelling within weeks.

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    Orchitis (Eng)

    Uploaded by

    Ferzy Awwali Fadhila
    241 views15 pages
    Epididymitis and orchitis are inflammations of the epididymis and testes, respectively, often caused by infection. Common causes include sexually transmitted infections in men ages 14-35 and E. coli in men under 14 or over 35. Symptoms include tenderness, swelling, and pain relieved by elevation. Diagnosis involves testing urine and urethral discharge. Treatment depends on the suspected cause but generally involves antibiotics. Complications can include hydrocele, abscess, or infertility, but with treatment pain usually improves within days and swelling within weeks.

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    Epididymitis and orchitis are inflammations of the epididymis and testes, respectively, often caused by infection. Common causes include sexually transmitted infections in men ages 14-35 and E. coli in men under 14 or over 35. Symptoms include tenderness, swelling, and pain relieved by elevation. Diagnosis involves testing urine and urethral discharge. Treatment depends on the suspected cause but generally involves antibiotics. Complications can include hydrocele, abscess, or infertility, but with treatment pain usually improves within days and swelling within weeks.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    241 views15 pages

    Orchitis (Eng)

    Uploaded by

    Ferzy Awwali Fadhila
    Epididymitis and orchitis are inflammations of the epididymis and testes, respectively, often caused by infection. Common causes include sexually transmitted infections in men ages 14-35 and E. coli in men under 14 or over 35. Symptoms include tenderness, swelling, and pain relieved by elevation. Diagnosis involves testing urine and urethral discharge. Treatment depends on the suspected cause but generally involves antibiotics. Complications can include hydrocele, abscess, or infertility, but with treatment pain usually improves within days and swelling within weeks.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 15

    EPIDIDYMITIS AND

    ORCHITIS
    Anita Suhadi, dr.
    Definition

    Epididymitis and orchitis are inflammation of the epididymis


    and testes, respectively, with or without infection

    American Family Physician, 2009


    Epidemiology

    2002 1 in 144 outpation visits (0.69 percent)

    In men 18 to 50 years of age

    Epididymitis is more common than orchitis

    Isolated orchitis is rare and is generally associated with

    MUMPS infection in prepubertal boys (13 years or younger)

    American Family Physician, 2009


    Risk Factor
    Sexual activity

    Bicycle or motorcycle riding

    Prolonged periods of sitting

    Urinary tract surgery

    Instrumentation (patient with prostatic obstruction)

    Anatomic abnormalities (meatal stenosis, posterior


    urethral valves)

    American Family Physician, 2009


    Etiology and Pathophysiology

    In men 14 to 35 y.o.a most commonly caused by sexually

    transmitted Neisseria gonorrhoeae, or Chlamydia


    trachomatis infection

    Younger than 14 y, or Older than 35 y, generally caused

    by infection with common urinary tract pathogens, such


    as E. coli.

    Mycobacterium tuberculosis, fungal and viral etiologies

    can occurred in HIV patients


    UK national guideline for the management
    of epididymo-orchitis, 2010
    Mumps give rise to inflammation of the testis which

    causes sperm antigens to be released into the blood


    circulation, resulting the anti-sperm antibodies in
    circulation

    Certain medication Amiodarone


    Sign
    Tenderness to palpation on the affected side

    Palpable swelling of the epididymis

    There may also be:

    Urethral discharge

    Secondary hydrocoele

    Erythema and/or oedema of the scrotum on the affected side

    Pyrexia

    Prehn sign, the relief of pain with the elevation of the testis

    Normal cremasteric reflex


    Differential Diagnosis

    American Family Physician, 2009


    Diagnostic Testing
    Gram stain and culture of swabbed urethral discharge

    (recommended to detect urethritis and gonococcal


    infection)

    Urinalysis and urine culture

    PCR assays for C. trachomatis and N. gonorrhoeae

    Color Doppler ultrasonography (to rule out testicular

    torsion by documenting blood flow)


    Management
    General Advice

    Appropriate rest

    Abstain from sexual intercourse until completed treatment and

    follow up

    Patient should given a detailed explanation of their condition with

    particular emphasis on the long term implication for the health of


    themselves and their partner.

    UK national guideline for the management


    of epididymo-orchitis, 2010
    Treatment
    For epididymo-orchitis most probably due to any sexually
    transmitted pathogen:

    Ceftriaxone 500mg IM single dose, plus


    Doxycycline 100mg by mouth twice daily for 10-14days

    If most probably due to Clamydia or other non-gonococcal


    organism (no intracelullar diplococci)

    Doxycycline 100mg by mouth twice daily for 10-14 days


    or
    Ofloxacin 200mg by mouth twice daily for 14days
    UK national guideline for the management
    of epididymo-orchitis, 2010
    For epididymo-orchitis most probably due to enteric
    organisms:
    Ofloxacin 200mg by mouth twice daily for 14 days or

    Ciprofloxacin 500mg by mouth twice daily for 10 days

    UK national guideline for the management


    of epididymo-orchitis, 2010
    Complication
    Reactive hydrocoele

    Abscess formation and infarction of the testicle (rare)

    Infertility in bilateral orchitis (13%)

    An ongoing (chronic) inflammation

    Managing epididymo-orchitis in general


    practice, Walker 2013
    Prognosis
    With treatment, pain typically improves within 1-3 days

    Take 2-4 weeks for induration to fully resolve

    Prepubescent boys with epididymitis need a urology

    referral because of the high incidence of urogenital


    abnormalities

    British Association for Sexual Health and


    HIV, 2011)
    Thankyou

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