EPIDIDYMO-ORCHITIS

EPIDIDYMO-ORCHITIS

Definition of Epididymo-orchitis

1. Epididymo-orchitis is an inflammation of the epididymis and testes.
2. It is a common urological emergency in men.

Clinical Signs and Symptoms

1. Acute epididymo-orchitis typically presents with sudden onset of pain, swelling, and inflammation in the scrotum.
2. Pain is usually severe and can radiate to the abdomen, lower back, and groin.
3. The affected testis may be swollen and tender to the touch.
4. Pyrexia (fever) may also be present.
5. In some cases, patients may experience nausea, vomiting, and urinary frequency.

Pathology

1. Epididymo-orchitis is usually caused by bacterial infection, most commonly by Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis.
2. The bacteria ascend from the urethra to the epididymis through the vas deferens.
3. The infection causes inflammation and edema in the epididymis and testes.
4. In severe cases, abscess formation can occur.

Types

1. Unilateral epididymo-orchitis is more common than bilateral epididymo-orchitis.
2. Epididymo-orchitis can be acute or chronic.
3. Acute epididymo-orchitis is usually caused by bacterial infection, while chronic epididymo-orchitis is often caused by recurrent infection or other underlying conditions.

Risk Factors

1. Older age
2. Diabetes mellitus
3. Urinary tract infection
4. Prostatic hyperplasia
5. Urethral stricture
6. Previous history of epididymo-orchitis

Investigations

1. Ultrasound of the scrotum to rule out other causes of scrotal swelling.
2. Blood tests to check for pyrexia and signs of infection.
3. Urine analysis to check for urinary tract infection.
4. Scrotal aspiration to obtain a sample for culture.

Complications

1. Abscess formation
2. Infertility
3. Chronic epididymo-orchitis
4. Testicular atrophy
5. Sepsis

Management

1. Antibiotics: broad-spectrum antibiotics are usually prescribed to cover common bacterial pathogens.
2. Analgesia: pain relief medication is prescribed to manage pain and discomfort.
3. Bed rest: rest is advised to reduce discomfort and promote healing.
4. Scrotal support: a scrotal support or a snug-fitting brief can help alleviate pain and discomfort.

Homoeopathic Therapeutics for Epididymo-orchitis

1. Belladonna: for acute epididymo-orchitis with severe pain and inflammation.
2. Calcarea carbonica: for chronic epididymo-orchitis with recurrent infection.
3. Lycopodium clavatum: for epididymo-orchitis with pain and swelling in the abdomen.
4. Pulsatilla nigricans: for epididymo-orchitis with pain and swelling in the groin.
5. Silica: for epididymo-orchitis with abscess formation.

Indications

1. Belladonna: for pain and inflammation.
2. Calcarea carbonica: for recurrent infection.
3. Lycopodium clavatum: for abdominal pain and swelling.
4. Pulsatilla nigricans: for groin pain and swelling.
5. Silica: for abscess formation.

Note: The indications mentioned above are general and may vary depending on the individual case.