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Q. What is epididymo-orchitis?

Answered by
Dr. Geetha Priyadarsini Kamminana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 30, 2018 and last reviewed on: Oct 09, 2018

Hi doctor,

My right inguinal hernia repair was performed before six years. Before seven months, I have developed right epididymitis and right spermatic cord hardness like stone. It was diagnosed as epididymo-orchitis.

There was a superficial abscess on the right side. Incision and drainage have been performed before two months. Still, I am having some pinching pain and hardness in the spermatic cord.

Currently, I take Amoxicillin 500 mg twice daily. In the past, I had Ciprofloxacin, Piperacillin and Tazobactam. I had a CBC, tumor markers, urinalysis, urine culture and biopsy of the wound. All the reports were normal.

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Hello,

Welcome to icliniq.com

Your present condition cannot be attributed to the inguinal hernia repair done six years ago. May I know what kind of repair was done? Either laparoscopic or open repair?

Acute epididymo-orchitis is a clinical syndrome consisting of pain, swelling and inflammation of the epididymis, with or without inflammation of the testes.

Chronic epididymitis refers to epididymal pain and inflammation (usually without scrotal swelling) that lasts for more than six months.

Symptoms of discomfort and pain at least 3 months in duration in the scrotum, testicle or epididymis are localized to one or each epididymis on clinical examination may be considered as chronic epididymitis.

The most common route of infection is local extension and is mainly due to infections spreading from the urethra (sexually transmitted infections - STIs) or from the bladder that is UTI (urinary tract infection) and prostatitis.

Your symptoms for the last 5 months can now be considered as chronic or acute progressed to chronic epididymitis.

The causes include infections like Chlamydial, tuberculous and also post-infectious.

Do you have any history of diabetes, recurrent UTI, BPH (benign prostatic hyperplasia) with prostatitis, cystitis or STDs?

For diagnosis, you need to get the following tests:

  1. Mid stream urine culture.
  2. Prostatic massage and culture of its secretions.
  3. Doppler ultrasound to rule out epididymal mass or cysts.
  4. Ultrasound abdomen to rule out cystitis.

The treatment includes both conservative and surgical. The conservative part includes antibiotics once the culture report arrives, NSAIDS (nonsteroidal anti-inflammatory drugs) or narcotic analgesics like Tapfree (combination of Tapentadol and Paracetamol). The surgical treatment is epididymectomy.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist


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