Ch116 Epididymorchitis

• More gradual onset
• Dysuria
• Urethral discharge
• History of urethral manipulation
• Recent urinary tract surgery (hypospadias, ureteral reimplantation);
• Catheterization
• Neurogenic bladder
• IImperforate anus; or known lower tract genitourinary anatomic abnormalities (ureteralor vasal ectopia, bladder exstrophy)

• Enlarged epididymis of mixed echogenicity surrounded by reactive fluid
• Increased testicular flow, except when there is such extensive swelling that ischemia may occur

• Prepurbertal male - gram-negative organisms (“nonspecific epididymitis,”)
• Postpubertal sexually active boys -  (N. gonorrhea, Chlamydia trachomatis)

Treatment of presumptive causative organism 

During or after treatment of the acute bacterial urinary and epididymal infections, radiologic evaluation of the urinary tract should be performed as with any UTI.