What are the complications associated with acute epididymitis and bacterial orchitis?

Updated: Aug 05, 2020
  • Author: Christina B Ching, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Complications associated with acute epididymitis and bacterial orchitis include the following:

  • Scrotal abscess and pyocele

  • Testicular infarction: Cord swelling can limit testicular artery blood flow

  • Fertility problems

  • Testicular atrophy

  • Cutaneous fistulization from rupture of an abscess through the tunica vaginalis (seen especially in tuberculosis)

  • Recurrence, chronic epididymitis, and orchialgia

With regard to the last item above, true local pain can be distinguished from referred pain by spermatic cord injection with 1% lidocaine. Refractory pain that is not improved by analgesics has also been managed by denervation of the spermatic cord.

With regard to fertility problems, sterility is uncommon after acute epididymitis, although the true incidence is unknown. Disturbances in the sperm quality secondary to leukocytospermia and inflammation are usually transient. More important is the far less common azoospermia, which is caused by the epididymal duct obstruction observed in men with untreated or improperly treated epididymitis. The incidence of this condition is unknown.

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