Epididymo-orchitis | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

What is New

Under investigations:

Testing a first pass urine for M. genitalium infection is included (previously considered)

Under treatment:

When most probably due to Chlamydia or other non gonococcal sexually transmitted pathogen (eg where gonorrhoea has been ruled out by gram stain and no risk factors for gonorrhoea identified) ofloxacin has been removed as an alternative first line and is now 2^nd line.

Advice on the use of fluoroquinolones antibiotics has been updated.

Introduction

Acute epididymo-orchitis is a clinical syndrome consisting of pain, swelling and inflammation of the epididymis +/- testes. The most common route of infection is local extension and is mainly due to infections spreading from the urethra (sexually transmitted pathogens) or the bladder (urinary pathogens).

Caution: Exclude torsion by careful clinical examination, especially if sudden onset, young (less than 20yrs usually, but can occur at any age); seek urgent urology opinion.
This is a surgical emergency – salvage of affected testis under 6 hours offers best outcome.

Aetiology

Clinical features

Investigations and diagnosis

Management, treatment and follow-up

References