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Epididymitis

**{{{Name|Epididymitis}}}**
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ICD-10	N45
ICD-O:	{{{ICDO}}}
ICD-9	604
OMIM	}}}
MedlinePlus	}}}
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Epididymitis is a medical condition where the epididymisbecomes inflamed. This condition may be mildly or very painful. Antibioticsmay be needed to control a component of infection.

Inhaltsverzeichnis

1 Diagnosis
2 Complications
3 Treatment
4 Epidemiology
5 See also

Diagnosis

Epididymitis can be hard to distinguish from testicular torsion. Sometimes, both can occur at the same time. Tests are needed to distinguish chronic epididymitis from a range of other disorders that can cause constant scrotal pain. These include: testicular cancer, enlarged scrotal veins (varicocele) or a cystwithin the epididymis. As well, the nerves in the scrotal area are connected to those of the abdomen, sometimes causing pain similar to a hernia(see referred pain). Tests may also include a physical examination and ultrasound. A urologistmay need to be consulted.

Chronic epididymitis is epididymitis which lasts past the first treatment. Typically, a second, longer round of treatment is used. Chronic epididymitis is characterised by inflammationeven when there is no infectionpresent. This condition can develop even without the presence of the previously described known causes. It is believed that the hypersensitivityof certain structures, including nerves and muscles, may cause or contribute to chronic epididymitis. As a last resort, surgerymay be employed.

Complications

Untreated, acute epididymitis can lead to a variety of complications. These include: chronic epididymitis, abscess, permanent damage or even destruction of the epididymisand testicle(resulting in infertilityand/or hypogonadism), and infectionmay spread to any other organor system of the body.

Treatment

Treatment options include: antibiotics, elevation of the scrotum, cold compresses applied regularly to the scrotum, hospitalisation in severe cases, check-ups to ensure the infectionhas cleared up. Pain is frequently so severe as to require opiate analgesics such as hydrocodone.

Epidemiology

This is usually caused by a secondary bacterial infectionthat is brought about by a variety of underlying conditions. Some cases of epididymitis are characterised by inflammationeven when there is no infection. Urinary tract infectionsare the most common cause. The bacteriain the urethraback-track through the urinary and reproductive structures to the epididymis. It can also be caused by genito-urinary surgery, including prostatectomy, urinary catheterization, congenital kidney and bladder problems, and STDs, like gonorrhoeaand chlamydia.

Acute epidiymitis has a tendency to spontaneously recur months or years after a successfully treated case.