Epididymitis

Summary: Urological referral usually indicated

Advice: Urological referral usually indicated.
Refer To: Any adult urologist (by generaic referral)

Contents:

Children

All children with epididymitis should be referred as emergencies to exclude torsion; they will all need full urological investigation to exclude congenital urinary tract abnormalities if a diagnosis of epididymitis is made. A diagnosis of epididymitis in children should only be made following surgical exploration to exclude torsion.

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Young men (under 45 years)

Young men should be treated with Ciprofloxacin & Doxycycline or Ofloxacin alone for 6 weeks, modified according to urine culture. Please refer to the GenitoMedical Clinic (Clinic 1A) as soon as possible for STD screening and contact tracing.

Urological referral should in young men only be considered if symptoms have not settled following 2 weeks of appropriate treatment, if there is severe systemic upset or if there are significant lower urinary tract symptoms.

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Older men (over 45 years)

Older men should be treated with antibiotics (e.g. Ofloxacin or Ciprofloxacin with Doxycycline).

Urine cultures should be performed and consideration given to screening for sexually-transmitted disease.

Urological referral should be considered if symptoms have not settled following 2 weeks of appropriate treatment or if there is severe systemic upset.

Consider tuberculosis if epididymitis fails to resolve or becomes chronic, especially if there is chronic abscess formation in the scrotum or discharge through the scrotal skin.

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Special information

This page contains guidelines and advice from professional bodies, together with information about the prescription of drugs. Since all NHS hospitals have local arrangements with their Primary Care Trusts (PCTs) about which medicines can be used, some drugs mentioned cannot be prescribed by local hospitals.

Treatment of patients will be planned with the Consultant responsible for care, taking into account those drugs which are or are not available at the local hospital and what is appropriate for optimum patient care.

Healthcare professionals are advised to check prescribing arrangements with their local hospital or PCT.

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