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Any form of epididymitis can be caused by genito-urinary surgery, including prostatectomy and urinary catheterization. Congestive epididymitis is a long-term complication of vasectomy. [10] [11] Chemical epididymitis may also result from drugs such as amiodarone. [12]
Epididymitis may also be characterized by discoloration and swelling of the testis, and fever. The cremasteric reflex in epididymitis is usually present. Testicular torsion, or more probably impending testicular infarction, can also produce a low-grade fever. [19] There is often an absent or decreased cremasteric reflex. [2]
[4] [2] In males, the phenomenon results in an uncomfortable testicular sensation. [5] It most often describes a temporary fluid congestion in the testicles or vulva, caused by prolonged sexual arousal without orgasm. [6] [7] The term epididymal hypertension is derived from the epididymis, a part of the male reproductive system. [8]
Acute infectious epididymitis are often associated with more tenderness and swelling, whereas chronic noninfectious epididymitis tend to have less tenderness and swelling upon examination. Thorough past medical history and physical examination can help with determining the diagnosis.
Orchitis can be related to epididymitis infection that has spread to the testicles (then called "epididymo-orchitis"), sometimes caused by the sexually transmitted infections chlamydia and gonorrhea. It has also been reported in cases of males infected with brucellosis. [2] Orchitis can also be seen during active mumps, particularly in ...
When the testis becomes swollen, in addition to the epididymis, this is called epididymo-orchitis. Epididymitis can be acute (lasting less than six weeks) or chronic (lasting equal to or more than six weeks). [17] Pain experienced due to chronic epididymitis is usually more dull compared to acute epididymitis and can be intermittent.
Epididymectomy is the surgical removal of the epididymis sometimes performed for post-vasectomy pain syndrome and for refractory cases of epididymitis. Epididymectomy is also performed for sterilization on some male animals of livestock species so they can be used to detect estrus in females ready for artificial insemination.
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...