It is a disease that can appear in young children as well as in adolescents or adults, so on this page we will try to bring together all these possibilities.
The inflammation of the epididymis is known as epididymitis, and orchitis refers to the inflammation of the testicle. When both occur at the same time, the condition is called orchiepididymitis. The epididymis which is where the sperm mature is located at the top and back of each testicle. The duct is long and folds many times on itself.
Comparison of epidymitis and healthy lateral epidymis
Comparison of epidymitis and healthy lateral epidymis
Comparison of epidymitis and frontal healthy epidymis
We must realize that orchiepididymitis can be the reactive result of early testicular torsion (especially in babies) and it could be confusing in some cases. That said, there are some clear differences that differentiate the two medical conditions:
In pediatrics, the incidence of these inflammatory conditions in Spain is approximately 1 or 2 of every 1,000 men a year, and its diagnosis is common as a cause of acute scrotum.
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This is short summary of the whole process: from the appointment request, to receiving the medical discharge after the treatment in some our Andromedi centers in Madrid, Seville or Canary islands (Tenerife)
These diseases often occur in boys. Therefore, it is recommended to visit a pediatric urologist and one or two consultations are enough.
Antibiotics are the treatment of choice for this type of infection, almost always combining several of them for better effects.
Parents should watch for symptoms of inflammation and pain in the scrotum. In the adult it is easier to diagnose.
It takes one or two weeks for the antibiotics to take effect, although scrotal swelling may be evident a couple of days later.
Men who have had epidimitis, orchitis, or both can resume sexual relations a week or ten days after treatment.
Often, these pathologies develop again on their own if the treatment is not carried out correctly, so it is important to have control checks.
With regard to newborn patients, predisposing factors for this disease include:
With regard to adult patients, the risk factors are very different:
Physical examination: The main difference between orchitis or orchiepididymitis and testicular torsion is that when the pain appears, you can already observe an increase in size, edema, heat and scrotal hyperemia. The position of the testicle is usually normal in the scrotum, it neither ascends nor becomes horizontal. The testis and epididymis are enlarged and painful upon palpation. If only of the epididymis is affected, it can be felt enlarged and presenting with selective pain next to a normal and less painful testicle. The child may have a reactional hydrocele and the contralateral scrotum may be somewhat edematous even with normal testis.
Complementary examinations: Diagnosis is fundamentally clinical. High-resolution color Doppler ultrasound will show good blood flow, unlike with torsion, and may rule out the fact that a small lump observed during physical examination could result in a cyst.
Treatment in our clinics in Madrid, Seville and the Canary Islands (Tenerife):
It will only be in a hospital if it is neonatal and if there is great urinary involvement in general, or there are predisposing factors mentioned. Otherwise, the baby can rest at home under constant medical supervision. The treatment consists of broad-spectrum antibiotics if the urinalysis or urine culture is positive, non-steroidal anti-inflammatory drugs (NSAIDs), analgesics and adequate rest.
Normally, the treatment period should not exceed one month. If the problems persist after this period, the situation should be carefully assessed by the urologist. Discomfort may be mild for a few weeks after treatment stops, but it usually goes away.
Early prognosis leads to better diagnosis and treatment. Although it is unusual, there is always the possibility of testicular atrophy and recurrence, which is advisable to warn parents about from the beginning. Also, there may be a scrotal abscess that requires surgical exploration.
Yes. If the infection is prolonged and not properly treated, reproductive damage may occur. It could also leave sequelae in terms of the size, shape or appearance of the testicle due to abnormal development or the extended lack of blood flow.
In a more acute phase of the infection, it is most likely for the patient not have a full erection or sexual desire due to pain and discomfort. Once the treatment begins and the inflammation and discomfort go away, masturbation or sexual intercourse can resume, although with some caution and care. There are some sexual positions more appropriate than others since they minimize friction in the scrotal area. Do not be afraid or embarrassed to consult with your urologist, we are on your side.
Dr. Pedro Lopez Pereira, a renowned urologist who has treated hundreds of children in his long experience at the Hospital La Paz in the Community of Madrid is the head of our Pediatric Unit and he performs all the interventions in addition to following up the results.
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