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Chapter: Paediatrics: Paediatric Surgery

Paediatrics: Orchitis and epididymitis

Orchitis is an uncommon condition in boys that presents with fever and testicular pain.

Orchitis and epididymitis

 

Orchitis

 

• Orchitis is an uncommon condition in boys that presents with fever and testicular pain.

• Approximately 20% of prepubertal patients with mumps develop orchitis.

• Diagnosis based on a history of recent mumps or parotitis; mumps orchitis is unilateral in 70% of cases.

• In 30% of cases, contralateral testicular involvement follows a few days later.

• This condition is rare in post-pubertal boys.

• Bacterial orchitis is usually associated with an epididymitis.

 

Epididymitis

 

• Usually associated with concomitant orchitis.

• In children epididymo-orchitis is usually associated with a urinary tract infection: infected urine refluxes down the vas.

• Structural abnormality in the renal tract should be excluded.

• Epididymo-orchitis presents with fever, urinary symptoms, and scrotal pain.

• In sexually-active adolescents epididymo-orchitis may be caused by gonorrhoea or Chlamydia.

• Epididymo-orchitis should be managed with antibiotics once urine has been sent for culture. Adolescents should be screened for sexually transmitted infection.

 

 

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