Epididymitis, orchitis and orchiepididymitis

Pediatric urology treatments

Epididymitis, orchitis and orchiepididymitis

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.

Epididymitis, orchitis and orchiepididymitis

Table of Contents

Definition

What are the differences between epididymitis, orchitis, and orchiepididymitis?

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

This disease condition that can appear in young children, adolescents, and adults alike. So on this page, we will try to combine all these possibilities.

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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En cumplimiento del Reglamento General de Protección de Datos le informamos que los datos por Vd. proporcionados serán objeto de tratamiento por parte de Andromedi con la finalidad de prestarle el servicio solicitado y/o contratado. Los datos no se cederán a terceros salvo en los casos en que exista una obligación legal. Para más información puede consultarla pinchando aquí.

Frequent causes

What factors predispose one to suffer from epididymitis or orchitis?

With regard to newborn patients, predisposing factors for this disease include:

With regard to adult patients, the risk factors are very different:

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Techniques and treatments

Diagnosis and treatment

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 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.

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Medical evaluation

Prognosis, and possible complications after treatment

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.

Frequent questions

Can this disease have complications related to fertility or reproduction?

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.

What is chronic epididymitis? How is it different from the common condition?
While common epididymitis (as well as orchitis or orchiepididymitis) usually has a favorable prognosis because the patient responds favorably to the antibiotics provided. We understand that chronic epididymitis has more chances of reappearing again and again or lasts over a prolonged period of time. These cases (more common in adults) are more sensitive and should be treated more keenly so that the causes of recurrence can be found and dealt with in a different plane.
Can you have sex or ejaculate while the infection is being treated?

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.

 

Dr. Natalio Cruz

Author

Dr. Natalio Cruz


El Dr. Cruz, con 25 años de experiencia médica, ha sido hasta 2016 Jefe de la Unidad de Andrología en el Servicio de Urología del Hospital Virgen del Rocío de Sevilla, Coordinador Nacional de Andrología de la Asociación Española de Urología (AEU) y Secretario General de la ESSM, cargos que ha delgado para centrarse de lleno en el ilusionante proyecto de ofrecer una consulta médica privada de alto nivel en Sevilla.

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