Materiały źródłowe

• #1 Orchitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/diagnosis-treatment/drc-20375865

  Treatment depends on the cause of orchitis. […] Antibiotics treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. […] Take all the antibiotics your healthcare professional prescribes, even if your symptoms ease sooner. This is to make sure that the infection is gone. […] Treatment aims to ease symptoms. […] Most people with orchitis start to feel better in 3 to 10 days. But it can take a few weeks for the scrotum to stop being tender. Sometimes, the pain and swelling can last for several months.

• #1 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  Empiric treatment of epididymitis should be initiated based on likely pathogens, before laboratory testing is complete. Treatment focuses on curing infection, improving symptoms, preventing transmission, and reducing future complications. If gonococcal or chlamydial infection is likely (patients 14 to 35 years of age), treatment should consist of ceftriaxone (Rocephin), a single 250-mg dose intramuscularly, and doxycycline (Vibramycin), 100 mg orally twice daily for 10 days. Azithromycin (Zithromax), a single 1-g dose orally, may be substituted for doxycycline if treatment compliance is questionable. If enteric organisms, such as coliform bacteria, are likely (patients younger than 14 years or older than 35 years) or the patient is allergic to cephalosporins or tetracyclines, treatment should include ofloxacin (Floxin; brand no longer available in the United States), 300 mg orally twice daily for 10 days, or levofloxacin (Levaquin), 500 mg orally once daily for 10 days. Patients who are immunocompromised (e.g., those with HIV) should receive the same treatment as those who are immunocompetent.

• #1 Epididymitis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm

  Recommended Regimens for Epididymitis […] For acute epididymitis most likely caused by chlamydia or gonorrhea: Ceftriaxone 500 mg* IM in a single dose […] PLUS […] Doxycycline 100 mg orally 2 times/day for 10 days […] For acute epididymitis most likely caused by chlamydia, gonorrhea, or enteric organisms (men who practice insertive anal sex): Ceftriaxone 500 mg* IM in a single dose […] PLUS […] Levofloxacin 500 mg orally once daily for 10 days […] For acute epididymitis most likely caused by enteric organisms only: Levofloxacin 500 mg orally once daily for 10 days. […] Treatment should be guided by bacterial cultures and antimicrobial susceptibilities. […] As an adjunct to therapy, bed rest, scrotal elevation, and nonsteroidal anti-inflammatory drugs are recommended until fever and local inflammation have subsided.

• #1 Epididymo-orchitis Empiric Therapy: Empiric Therapy Regimens

  https://emedicine.medscape.com/article/2018356-overview

  The CDC recommends the following regimen: […] Levofloxacin 500 mg PO daily for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Levofloxacin 500 mg PO daily for 10 days. […] BASHH guidelines recommends the following regimen be considered: […] Ofloxacin 200 mg PO BID for 14 days or Levofloxacin 500 mg PO daily for 10 days. […] If quinolones are contraindicated, BASHH recommends amoxicillin-clavulanate 625 mg PO TID for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Ofloxacin 200 mg PO BID for 10 days. […] Options include the following: […] Trimethoprim/sulfamethoxazole 3-6 mg/kg PO q12h for 10d or Amoxicillin/clavulanate 15-20 mg/kg PO q12h for 10d. […] Approaches include the following: […] Reduce physical activity […] Scrotal support and elevation […] Ice packs […] Anti-inflammatory agents […] Analgesics, including nerve blocks […] Sitz baths […] Avoid urethral instrumentation.

• #1 Epididymo-orchitis Empiric Therapy: Empiric Therapy Regimens

  https://emedicine.medscape.com/article/2018356-overview

  STI-associated epididymo-orchitis is more likely in men younger than 35 years with more than one partner in the past 12 months, particularly if urethral discharge is present. […] The 2021 guidelines from the US Centers for Disease Control and Prevention (CDC) recommend the following regimen for treatment aimed at eradication of Neisseria gonorrhoeae and Chlamydia trachomatis: […] Ceftriaxone 500 mg (1 g in patients weighing 150 kg) IM once plus Doxycycline 100 mg PO BID for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Levofloxacin 500 mg PO daily for 10 days. […] For first-line empirical treatment of epididymo-orchitis most probably due to any sexually transmitted pathogen, the 2020 United Kingdom British Association for Sexual Health and HIV (BASHH) guidelines recommend:

• #1 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  In addition to antibiotic treatment, analgesics, scrotal elevation, limitation of activity, and use of cold packs are helpful in the treatment of epididymitis. Patients should be advised of possible complications, including sepsis, abscess, infertility, and extension of the infection. Epididymitis and orchitis usually can be treated in the outpatient setting with close follow-up. Inpatient care is recommended for intractable pain, vomiting (because of the inability to take oral antibiotics), suspicion of abscess, failure of outpatient care, or signs of sepsis. […] Orchitis treatment is mostly supportive and should include bed rest and the use of hot or cold packs for pain. Antibacterial medications are not indicated for the treatment of viral orchitis, and most cases of mumps-associated orchitis resolve spontaneously after three to 10 days. Epididymoorchitis requires appropriate antibiotic coverage, as with epididymitis.

• #1 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition. […] Treatment may include: […] Antibiotics, if the infection is caused by bacteria. (In the case of gonorrhea or chlamydia, sexual partners must also be treated.) […] Anti-inflammatory medicines. […] Pain medicines. […] Bed rest with the scrotum elevated and ice packs applied to the area. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] Mumps orchitis has no effective treatment, and the outcome can vary. Men who have had mumps orchitis can become sterile.

• #1 Orchitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/orchitis

  Orchitis may cause pain and swelling. It is typically treated with supportive underwear, cold packs, medicines called anti-inflammatories and, in some instances, medicines called antibiotics. But it can take several weeks or even months for tenderness in the scrotum to go away. […] Treatment depends on the cause of orchitis. […] Antibiotics treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. […] Take all the antibiotics your healthcare professional prescribes, even if your symptoms ease sooner. This is to make sure that the infection is gone. […] Treatment aims to ease symptoms. You might: Take nonsteroidal anti-inflammatory medicines, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). Be sure to talk with your healthcare professional before taking these medicines if you take blood thinners or have kidney disease. […] Most people with orchitis start to feel better in 3 to 10 days. But it can take a few weeks for the scrotum to stop being tender. Sometimes, the pain and swelling can last for several months.

• #1 Orchitis Treatment & Management: Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/777456-treatment

  Supportive treatment includes the following: […] Most importantly, the physician must rule out testicular torsion. […] Second, the physician should consider epididymo-orchitis and, if highly suspected, treat appropriately. This usually involves starting empiric antibiotic therapy. […] Orchitis complicated by a reactive hydrocele or pyocele may require surgical drainage to reduce the pressure in the tunica. […] Follow-up care with a urologist is appropriate for an uncomplicated presentation of orchitis. […] Symptoms of isolated orchitis usually resolve spontaneously in approximately 3-10 days, whereas epididymitis will usually resolve in a similar time frame after initiation of antibiotic treatment. […] Supportive therapy includes the following: […] Treatment can usually be performed as an outpatient with close follow-up. Indications for admission include the following:

• #1 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  If there is suspicion of a sexually transmitted pathogen, then treatment should consist of ceftriaxone 250 mg single shot intramuscularly and doxycycline 100 mg twice daily for 10 to 14 days. […] The management of orchitis is usually on an outpatient basis; severe complications are rare. […] Most patients recover without sequelae; however, there are reports of the following complications: Testicular atrophy (up to 60% of cases demonstrate some degree of atrophy), Impaired fertility, Sterility (rare), Epididymitis, Reactive hydrocele. […] The majority of cases do not require consultations. In some complicated cases, consultations may be required such as: Formation of abscess or infarction of testicle may require surgical consultation.

• #1 Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06753-w

  All patients received triple therapy of chemotherapy-surgery-pharmacotherapy and definite diagnosis was confirmed through histopathology of surgical specimens. […] We recommend patients with advanced TBEO to receive triple therapy of chemotherapy-surgery-pharmacotherapy. Physicians should pay more attention to patients sexual function and fertility during follow up after treatment completed. […] Surgical indications for patients with TBEO in our center including: (1) Regular anti-tuberculosis pharmacotherapy for 12 months was completed but tuberculous lesions were still not controlled. (2) TBEO was diagnosed in advanced stage with widely spread of M. tuberculosis. (3) Tuberculous complications including hydrocele, abscess, sinus or fistula were observed. (4) Clinical diagnosis of scrotal tumors was suspected. (5) Clinical diagnosis was nonspecific bacterial epididymo-orchitis but the efficacy of antibiotic treatment was limited. Patients with clinical diagnosis of TBEO received anti-tuberculosis chemotherapy for 24 weeks before surgery. Surgical procedure (orchiectomy, epididymectomy or epididymo-orchidectomy) and postoperative anti-tuberculosis therapy with 4 drugs (rifampicin, isoniazid, ethambutol and pyrazinamide) for 612 months were performed in all patients.

• #1 Epididymitis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm

  Men who have acute epididymitis confirmed or suspected to be caused by N. gonorrhoeae or C. trachomatis should be advised to abstain from sexual intercourse until they and their partners have been treated and symptoms have resolved. […] Men should be instructed to return to their health care providers if their symptoms do not improve 72 hours after treatment. […] Signs and symptoms of epididymitis that do not subside in 3 days require reevaluation of the diagnosis and therapy.

• #1 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Sexual partners […] Partner notification and treatment are recommended for all patients with epididymo-orchitis secondary to gonorrhoea, chlamydia and non-gonococcal urethritis (NGU) or of indeterminate aetiology and subsequent MSU negative. […] Follow-up […] If there is no improvement in the patient’s condition after three days, the diagnosis should be reassessed and therapy re-evaluated. […] Further follow-up is recommended at two weeks to assess compliance with treatment, partner notification and improvement of symptoms. […] The swelling and tenderness can persist after antimicrobial therapy is completed but should be significantly improved. […] Where there is little improvement, further investigations such as an ultrasound scan or surgical assessment should be considered.

• #1 Orchitis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/21658-orchitis

  Orchitis causes pain and swelling in one or both of your testicles. Treatment usually involves antibiotics. At-home care can also help relieve symptoms. […] Getting rid of orchitis depends on its exact cause. In Treatment options may include: Antibiotics. Antibiotics kill bacterial infections. If an STI causes orchitis, your sexual partners must also receive treatment. If they dont, you may continue passing the STI to each other. […] Without treatment, youre more likely to have complications or long-term damage, including severe illness, infertility or the loss of a testicle. […] With proper diagnosis and treatment, the outlook for orchitis is good. Infertility and other long-term problems are rare.

• #1 Orchitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860

  Orchitis may cause pain and swelling. It is typically treated with supportive underwear, cold packs, medicines called anti-inflammatories and, in some instances, medicines called antibiotics. But it can take several weeks or even months for tenderness in the scrotum to go away. […] Most often, orchitis gets better with supportive care. It can take several weeks or months before the pain and swelling go away. […] To help prevent orchitis: Get the vaccine against mumps, the most common cause of viral orchitis. Practice safe sex to help protect against STIs that can cause bacterial orchitis. Talk with your healthcare professional if you have trouble with urination. That may mean you have a blockage or other condition that can lead to orchitis.

• #1 Orchitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26310

  Overall, the majority of viral cases and antibiotic-treated cases will resolve without any complications. Most of the patients are treated as outpatients. […] Complications are preventable with accurate diagnosis and efficient management of patients. Most patients recover without sequelae; however, there are reports of the following complications: Testicular atrophy (up to 60% of cases demonstrate some degree of atrophy), Impaired fertility, Sterility (rare), Epididymitis, Reactive hydrocele. […] The management of orchitis is usually on an outpatient basis; severe complications are rare. The condition still merits the involvement of an interprofessional healthcare team.

• #1 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Surgical […] Scrotal exploration if a torsion or tumour cannot be ruled out and for the complications of acute epididymitis and orchitis (eg, abscess, testicular infarction). […] Epididymo-orchitis complications […] Complications are more often seen in patients with uropathogen-related epididymo-orchitis than STI-associated epididymo-orchitis. […] Sepsis. […] Abscess formation and ischaemia/infarction of the testicle. […] Reactive hydrocele. […] Testicular atrophy and subfertility – eg, mumps orchitis. […] Chronic scrotal pain. […] Mumps epididymo-orchitis can lead to testicular atrophy, sub-fertility and infertility.

• #2 Orchitis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/21658-orchitis

  Orchitis causes pain and swelling in one or both of your testicles. Treatment usually involves antibiotics. At-home care can also help relieve symptoms. […] Getting rid of orchitis depends on its exact cause. In Treatment options may include: Antibiotics. Antibiotics kill bacterial infections. If an STI causes orchitis, your sexual partners must also receive treatment. If they dont, you may continue passing the STI to each other. […] Without treatment, youre more likely to have complications or long-term damage, including severe illness, infertility or the loss of a testicle. […] With proper diagnosis and treatment, the outlook for orchitis is good. Infertility and other long-term problems are rare.

• #2 Orchitis Treatment & Management: Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/777456-treatment

  Supportive treatment includes the following: […] Most importantly, the physician must rule out testicular torsion. […] Second, the physician should consider epididymo-orchitis and, if highly suspected, treat appropriately. This usually involves starting empiric antibiotic therapy. […] Orchitis complicated by a reactive hydrocele or pyocele may require surgical drainage to reduce the pressure in the tunica. […] Follow-up care with a urologist is appropriate for an uncomplicated presentation of orchitis. […] Symptoms of isolated orchitis usually resolve spontaneously in approximately 3-10 days, whereas epididymitis will usually resolve in a similar time frame after initiation of antibiotic treatment. […] Supportive therapy includes the following: […] Treatment can usually be performed as an outpatient with close follow-up. Indications for admission include the following:

• #2 Orchitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/orchitis

  Orchitis may cause pain and swelling. It is typically treated with supportive underwear, cold packs, medicines called anti-inflammatories and, in some instances, medicines called antibiotics. But it can take several weeks or even months for tenderness in the scrotum to go away. […] Treatment depends on the cause of orchitis. […] Antibiotics treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. […] Take all the antibiotics your healthcare professional prescribes, even if your symptoms ease sooner. This is to make sure that the infection is gone. […] Treatment aims to ease symptoms. You might: Take nonsteroidal anti-inflammatory medicines, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). Be sure to talk with your healthcare professional before taking these medicines if you take blood thinners or have kidney disease. […] Most people with orchitis start to feel better in 3 to 10 days. But it can take a few weeks for the scrotum to stop being tender. Sometimes, the pain and swelling can last for several months.

• #2 Epididymo-orchitis Empiric Therapy: Empiric Therapy Regimens

  https://emedicine.medscape.com/article/2018356-overview

  STI-associated epididymo-orchitis is more likely in men younger than 35 years with more than one partner in the past 12 months, particularly if urethral discharge is present. […] The 2021 guidelines from the US Centers for Disease Control and Prevention (CDC) recommend the following regimen for treatment aimed at eradication of Neisseria gonorrhoeae and Chlamydia trachomatis: […] Ceftriaxone 500 mg (1 g in patients weighing 150 kg) IM once plus Doxycycline 100 mg PO BID for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Levofloxacin 500 mg PO daily for 10 days. […] For first-line empirical treatment of epididymo-orchitis most probably due to any sexually transmitted pathogen, the 2020 United Kingdom British Association for Sexual Health and HIV (BASHH) guidelines recommend:

• #2 Epididymo-orchitis treatment guidelines – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/health-professionals/treatment-guidelines/epididymo-orchitis-treatment-guidelines

  Epididymo-orchitis is the clinical syndrome of pain and swelling of the epididymis and testis which occurs in the context of a urethral or a urinary tract infection. […] Antibiotic treatment depends on the presumed source of infection and should aim to cover the most likely bacterial pathogens. […] Simple analgesics, scrotal support, limitation of activity and use of cold packs can be helpful. […] Patients with acute epididymo-orchitis on appropriate treatment should generally improve within 48 – 72 hours. […] If there is no improvement the diagnosis should be re-evaluated or referral considered. […] Epididymo-orchitis likely caused by sexually acquired pathogen: Doxycycline 100 mg PO, twice daily for 14 days. […] If suspect gonorrhoea, add Ceftriaxone 500 mg IM, stat. […] Alternative to Doxycycline: Azithromycin 1 g PO, stat, repeated in 1 week.

• #2 Epididymo-orchitis Empiric Therapy: Empiric Therapy Regimens

  https://emedicine.medscape.com/article/2018356-overview

  Ceftriaxone 1g IM plus Doxycycline 100 mg PO BID for 14 days. […] For epididymitis likely caused by sexually transmitted chlamydia and gonorrhoea and enteric organisms, BASHH guidelines recommend considering the following regimen: […] Ceftriaxone 1g IM plus Ofloxacin 200 mg PO BID for 10 days. […] For epididymo-orchitis most probably due to enteric pathogens, BASHH guidelines recommend considering the following regimen: […] Ofloxacin 200 mg PO BID or Levofloxacin 500 mg PO once daily. […] If an STI is suspected, advise the patient to use condoms or abstain from sex for 7 days after treatment is initiated. Sexual partners should be referred for evaluation and treatment to eliminate the possibility of reinfection. […] Epididymo-orchitis due to infection with gram-negative enteric organisms is most likely in men older than 35 years with a low-risk sexual history, with recent urological instrumentation or urinary tract infection, or with positive urine dipstick for leukocytes and nitrites. If an enteric organism is suspected, fluoroquinolones are the preferred antibiotic, as they have excellent penetration into the testes.

• #2 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  If a quinolone antibiotic is contra-indicated, treat with oral co-amoxiclav 500/125 mg three times a day for 10 days. […] If epididymitis is most likely due to an STI and/or enteric organism (eg, men who have insertive anal sex): […] Consider treating empirically with ceftriaxone 1 g IM, depending on local prescribing protocols, plus oral ofloxacin 200 mg twice daily for 14 days. […] If a quinolone antibiotic is contra-indicated, treat with oral co-amoxiclav 500/125 mg three times a day for 10 days. […] If treating with fluoroquinolone antibiotics in primary care: advise that these can very rarely cause long-lasting, potentially irreversible adverse effects affecting the tendons, muscles, joints, and/or central nervous system. […] Advise stopping fluoroquinolone antibiotic treatment immediately and seeking immediate medical advice if the patient develops serious tendon, muscle, or joint pain or inflammation, peripheral neuropathy or any other serious CNS adverse effect.

• #2 Epididymo-orchitis treatment guidelines – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/health-professionals/treatment-guidelines/epididymo-orchitis-treatment-guidelines

  Epididymo-orchitis likely caused by urinary tract pathogen: Cephalexin 500mg PO, four times a day for 14 days. […] OR Amoxycillin + clavulanate 875+125mg PO, twice daily for 14 days. […] Alternative antibiotics: Ciprofloxacin 500mg PO, twice daily for 14 days. […] OR Norfloxacin 400mg PO, twice daily for 14 days.

• #2 Epididymitis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm

  Recommended Regimens for Epididymitis […] For acute epididymitis most likely caused by chlamydia or gonorrhea: Ceftriaxone 500 mg* IM in a single dose […] PLUS […] Doxycycline 100 mg orally 2 times/day for 10 days […] For acute epididymitis most likely caused by chlamydia, gonorrhea, or enteric organisms (men who practice insertive anal sex): Ceftriaxone 500 mg* IM in a single dose […] PLUS […] Levofloxacin 500 mg orally once daily for 10 days […] For acute epididymitis most likely caused by enteric organisms only: Levofloxacin 500 mg orally once daily for 10 days. […] Treatment should be guided by bacterial cultures and antimicrobial susceptibilities. […] As an adjunct to therapy, bed rest, scrotal elevation, and nonsteroidal anti-inflammatory drugs are recommended until fever and local inflammation have subsided.

• #2 Epididymo-orchitis Empiric Therapy: Empiric Therapy Regimens

  https://emedicine.medscape.com/article/2018356-overview

  The CDC recommends the following regimen: […] Levofloxacin 500 mg PO daily for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Levofloxacin 500 mg PO daily for 10 days. […] BASHH guidelines recommends the following regimen be considered: […] Ofloxacin 200 mg PO BID for 14 days or Levofloxacin 500 mg PO daily for 10 days. […] If quinolones are contraindicated, BASHH recommends amoxicillin-clavulanate 625 mg PO TID for 10 days. […] For acute epididymitis in men who practice insertive anal sex: Ceftriaxone 500 mg IM once plus Ofloxacin 200 mg PO BID for 10 days. […] Options include the following: […] Trimethoprim/sulfamethoxazole 3-6 mg/kg PO q12h for 10d or Amoxicillin/clavulanate 15-20 mg/kg PO q12h for 10d. […] Approaches include the following: […] Reduce physical activity […] Scrotal support and elevation […] Ice packs […] Anti-inflammatory agents […] Analgesics, including nerve blocks […] Sitz baths […] Avoid urethral instrumentation.

• #2 Orchitis – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/orchitis

  Orchitis is infection of the testes, typically with mumps virus. Symptoms are testicular pain and swelling. Diagnosis is clinical. Treatment is symptomatic. Antibiotics are given only if bacterial infection is identified. […] Treatment of Orchitis […] Supportive care with analgesics and hot or cold packs is sufficient if bacterial infection has been ruled out. Bacterial infections (usually causing epididymo-orchitis) are treated with appropriate antibiotics. […] Urologic follow-up is recommended.

• #2 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  In addition to antibiotic treatment, analgesics, scrotal elevation, limitation of activity, and use of cold packs are helpful in the treatment of epididymitis. Patients should be advised of possible complications, including sepsis, abscess, infertility, and extension of the infection. Epididymitis and orchitis usually can be treated in the outpatient setting with close follow-up. Inpatient care is recommended for intractable pain, vomiting (because of the inability to take oral antibiotics), suspicion of abscess, failure of outpatient care, or signs of sepsis. […] Orchitis treatment is mostly supportive and should include bed rest and the use of hot or cold packs for pain. Antibacterial medications are not indicated for the treatment of viral orchitis, and most cases of mumps-associated orchitis resolve spontaneously after three to 10 days. Epididymoorchitis requires appropriate antibiotic coverage, as with epididymitis.

• #2 Orchitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26310

  Overall, the majority of viral cases and antibiotic-treated cases will resolve without any complications. Most of the patients are treated as outpatients. […] Complications are preventable with accurate diagnosis and efficient management of patients. Most patients recover without sequelae; however, there are reports of the following complications: Testicular atrophy (up to 60% of cases demonstrate some degree of atrophy), Impaired fertility, Sterility (rare), Epididymitis, Reactive hydrocele. […] The management of orchitis is usually on an outpatient basis; severe complications are rare. The condition still merits the involvement of an interprofessional healthcare team.

• #2 Treating Epididymitis and Orchitis | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/treating-epididymitis-and-orchitis

  You have inflammation of the epididymis (epididymitis) and testicle (orchitis). This is likely from an infection. Treatment includes medicine to get rid of the infection. It also includes medicine and other methods to ease symptoms. […] Acute epididymitis is most often treated with oral antibiotics. You may also be given a shot (injection) of antibiotics. Be sure to take all of your medicine until it is gone, even if you feel better. […] You may be prescribed medicine to reduce swelling and tenderness. […] You will most likely need to rest for 3 to 4 days until swelling and fever are gone. […] If your testicles are swollen, wear an athletic supporter (jockstrap) or spandex shorts. This may help control swelling and ease symptoms. […] To ease swelling, use an ice pack wrapped in a thin towel on the scrotum. Once swelling is gone, sit in a warm bath to increase blood flow to the area. […] The inflammation will go away with treatment. But you may have an achy feeling in the testicles for 2 to 4 weeks. This does not mean the infection has come back. The testicles just take time to heal.

• #2 Epididymitis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm

  To prevent complications and transmission of STIs, presumptive therapy for all sexually active men is indicated at the time of the visit before all laboratory test results are available. […] Treatment goals for acute epididymitis are 1) microbiologic infection cure, 2) improvement of signs and symptoms, 3) prevention of transmission of chlamydia and gonorrhea to others, and 4) decreased potential for chlamydial or gonococcal epididymitis complications (e.g., infertility or chronic pain). […] Although the majority of men with acute epididymitis can be treated on an outpatient basis, referral to a specialist and hospitalization should be considered when severe pain or fever indicates other diagnoses (e.g., torsion, testicular infarction, abscess, or necrotizing fasciitis) or when men are unable to comply with an antimicrobial regimen.

• #2 Orchitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26310

  Orchitis diagnosis is usually from history and physical findings. Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] In an emergency, clinicians must distinguish between torsion and inflammation of the testis. Antibiotics are not necessary for viral causes of the disease. Supportive therapies such as bed rest, antipyretics, analgesics, scrotal support, and hot or cold packs for analgesia are advisable. […] Antibiotics should start empirically based on the likely pathogens according to age and sexual history. […] Sexual partners of the patient with sexually transmitted pathogens should receive treatment. The inability to take oral antibiotics, signs of sepsis, and failure of previous outpatient therapy should warrant inpatient therapy.

• #2 Epididymitis – Genitourinary Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/epididymitis

  If sepsis is suspected, an aminoglycoside such as tobramycin or a 3rd-generation cephalosporin such as ceftriaxone may be useful until the infecting organism and its sensitivities are known. […] Abscess and pyocele usually require surgical drainage. […] Recurrent bacterial epididymitis secondary to incurable chronic urethritis or prostatitis occasionally can be prevented by vasectomy. […] An epididymectomy, occasionally done for chronic epididymitis, may not relieve symptoms. […] Treatment of nonbacterial epididymitis includes the above general measures, but antimicrobial therapy is not warranted. […] Nerve block of the spermatic cord with local anesthesia can relieve symptoms in severe, persistent cases.

• #2 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Surgical […] Scrotal exploration if a torsion or tumour cannot be ruled out and for the complications of acute epididymitis and orchitis (eg, abscess, testicular infarction). […] Epididymo-orchitis complications […] Complications are more often seen in patients with uropathogen-related epididymo-orchitis than STI-associated epididymo-orchitis. […] Sepsis. […] Abscess formation and ischaemia/infarction of the testicle. […] Reactive hydrocele. […] Testicular atrophy and subfertility – eg, mumps orchitis. […] Chronic scrotal pain. […] Mumps epididymo-orchitis can lead to testicular atrophy, sub-fertility and infertility.

• #2 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Sexual partners […] Partner notification and treatment are recommended for all patients with epididymo-orchitis secondary to gonorrhoea, chlamydia and non-gonococcal urethritis (NGU) or of indeterminate aetiology and subsequent MSU negative. […] Follow-up […] If there is no improvement in the patient’s condition after three days, the diagnosis should be reassessed and therapy re-evaluated. […] Further follow-up is recommended at two weeks to assess compliance with treatment, partner notification and improvement of symptoms. […] The swelling and tenderness can persist after antimicrobial therapy is completed but should be significantly improved. […] Where there is little improvement, further investigations such as an ultrasound scan or surgical assessment should be considered.

• #2 Epididymitis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm

  Men who have acute epididymitis confirmed or suspected to be caused by N. gonorrhoeae or C. trachomatis should be advised to abstain from sexual intercourse until they and their partners have been treated and symptoms have resolved. […] Men should be instructed to return to their health care providers if their symptoms do not improve 72 hours after treatment. […] Signs and symptoms of epididymitis that do not subside in 3 days require reevaluation of the diagnosis and therapy.

• #2 Orchitis: Causes, symptoms., treatment

  https://www.medicalnewstoday.com/articles/orchitis

  A person can take a couple of steps to help prevent orchitis. They include practicing safer sex by limiting the number of sexual partners, wearing condoms, and getting the MMR vaccination. […] Orchitis refers to swelling and tenderness of one or both testicles. The condition typically occurs alongside certain infections, including mumps and STIs. While most people fully recover, some may develop complications such as infertility. A person can help prevent the condition through vaccination and practicing safe sex practices.

• #3 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  If there is suspicion of a sexually transmitted pathogen, then treatment should consist of ceftriaxone 250 mg single shot intramuscularly and doxycycline 100 mg twice daily for 10 to 14 days. […] The management of orchitis is usually on an outpatient basis; severe complications are rare. […] Most patients recover without sequelae; however, there are reports of the following complications: Testicular atrophy (up to 60% of cases demonstrate some degree of atrophy), Impaired fertility, Sterility (rare), Epididymitis, Reactive hydrocele. […] The majority of cases do not require consultations. In some complicated cases, consultations may be required such as: Formation of abscess or infarction of testicle may require surgical consultation.

• #3 Epididymitis and Orchitis – Oregon Urology Institute

  https://oregonurology.com/epididymitis-and-orchitis/

  At-home symptom management for relief includes: Applying a cold gel pack or bag of ice to the area for 15 minutes every few hours to reduce pain and swelling, Wearing a jock strap to support your scrotum, Taking over-the-counter pain medications like: Acetaminophen (Tylenol), Ibuprofen (Advil, Motrin), Naproxen (Aleve), Limiting activities that could make the condition worse, such as heavy lifting or strenuous exercise.

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