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Epididymitis is a medical condition in which there is
inflammation of the epididymis (a curved structure at
the back of the testicle in which sperm matures and is
stored). This condition may be mildly to very painful,
and the scrotum (sac containing the testicles) may
become red, warm and swollen. It may be acute (of sudden
onset) or rarely chronic.
Epididymitis is the most frequent cause of sudden
scrotal pain. In contrast with men who have testicular
torsion, the cremaster reflex (elevation of the testicle
in response to stroking the upper inner thigh) is not
altered. If the diagnosis is not entirely clear from the
patient's history and physical examination, a Doppler
ultrasound scan can confirm increased flow of blood to
the affected epididymis.
Infection is the most common cause. In sexually active
men, Chlamydia trachomatis is the most frequent
causative microbe, followed by E. coli and Neisseria
gonorrhoeae. In children, it may follow an infection in
another part of the body (for example, a viral illness),
or there may be an associated urinary tract anomaly.
Another cause is sterile reflux of urine through the
ejaculatory ducts. |
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