Table of contents
Expand All Topics
Acute epididymitis
What's new
Updated 2024 EAU guidelines for the diagnosis and management of acute epididymitis .
Background
Overview
Definition
Acute epididymitis is the acute inflammation of the epididymis characterized by pain and scrotal swelling present for < 6 weeks.
1
Pathophysiology
Acute epididymitis is caused by a bacterial ascent (UTIs or STIs), viral genesis (adenovirus, enterovirus), fungi (C. albicans, Histoplasma capsulatum), parasites (Trichomonas vaginalis, Schistosoma species, Filariasis), drug-induced (amiodaron), rheumatic (Behçet's disease, vasculitis, Henoch-Schönlein purpura), obstruction (vasectomy), genital trauma, and sterile reflux.
2
Disease course
The inflammation of the epididymis results in acute epididymis, which causes clinical manifestations of gradual unilateral scrotal pain and epididymal swelling with concurrent symptoms of fever, hematuria, dysuria, and urinary frequency. Disease progression may lead to abscess formation or Fournier gangrene, infertility, and chronic pain.
1
Prognosis and risk of recurrence
Acute epididymis is not associated with an increase in mortality.
2
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of acute epididymitis are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2024), the Center for Disease Control (CDC 2021), the International Union Against Sexually Transmitted Infections (IUSTI 2017), and the American Academy of Family Physicians (AAFP 2016).
1
2
3
4
5