Which tests are helpful in the diagnosis of epididymitis?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In epididymitis, a microscopic examination of the urethral secretions is helpful only in cases with very mild symptoms, when torsion is not a consideration. Leukocytes and bacteria on a Gram stain would suggest epididymitis (unless the patient previously had a vasectomy).

Torsion of the spermatic cord and torsion of a testicular appendage would be the main differential diagnosis considerations. Spermatic cord torsion is normally diagnosed using ultrasonography, which is very sensitive and specific, or with surgical exploration. The latter does not alter the outcome of epididymitis if the testicle is inadvertently explored to pursue torsion.


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