What is included in emergency department (ED) care of acute epididymitis?

Updated: Apr 04, 2018
  • Author: Michelle DiMare, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Patients with testicular or scrotal pain require immediate evaluation in order to identify and quickly treat potential cases of testicular torsion. Although most cases of torsion occur in patients aged 12-18 years, testicular torsion should be considered in any patient aged 12-30 years who presents with a scrotal complaint. Obtain immediate urologic consultation if unable to clearly differentiate testicular torsion from epididymitis or other scrotal pathology.

In a 21-year retrospective study of 252 pediatric patients diagnosed with epididymitis or epididymo-orchitis, age at first presentation was 10.92 ± 4.08 years. The majority of cases occurred during the pubertal period (11-14 years), and few patients younger than 2 years were diagnosed with epididymitis (4%). A total of 69 boys (27.4%) experienced a second episode of epididymitis. Scrotal ultrasound results were consistent with epididymitis in 87.3% of cases (144 of 165). [19]

Acute epididymitis is treated with antibiotic therapy, analgesics for pain control, and supportive care, which includes scrotal elevation and support, application of an ice pack, and, in some cases, spermatic cord block.

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