Management of epididymo-orchitis in primary care: results from a large UK primary care database

Nicholson, Amanda; Rait, Greta; Murray‐Thomas, Tarita; Hughes, Gwenda; Mercer, Catherine H; Cassell, Jackie A

doi:10.3399/bjgp10x532413

Cited by 58 publications

(38 citation statements)

References 23 publications

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“…Epididymitis and epididymo-orchitis represent the commonest cause of acute scrotum, with a prevalence of 40 per 10,000 [18]. The underlying cause is usually bacterial; rarely a fungal infection is responsible.…”

Section: Epididymitismentioning

confidence: 99%

A review of ultrasound imaging in scrotal emergencies

Yusuf

Sidhu

2013

J Ultrasound

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Scrotal emergencies represent a small proportion of admissions to the emergency department; however, the intimate nature and potential for serious outcome often cause great anxiety. Rapid assessment is required to exclude fertility-threatening conditions and expedite surgical management. Ultrasound is an essential tool in acute scrotal assessment as it allows rapid, radiation-free, highresolution imaging and, importantly, assessment of vascularity with colour Doppler imaging. In the presentation of the acute scrotum, the ''on-call'' practitioner will frequently be asked to exclude pathology requiring surgical management, in particular torsion of the spermatic cord. To provide an accurate evaluation the individual is required to have an understanding of scrotal anatomy, sonographic technique and recognition of pathology. This review article will familiarise the reader with the sonographic findings of common acute scrotal pathology.Sommario Le emergenze scrotali rappresentano una piccola percentuale di accessi al pronto soccorso, ma la natura intima e la possibilità di esiti seri sono spesso causa di grande ansia. E' necessaria una valutazione rapida, al fine di escludere condizioni di pericolo per la fertilità e accelerare il trattamento chirurgico. L'ecografia è uno strumento essenziale per la valutazione dello scroto acuto in quanto rapida, esente da radiazione, ad alta risoluzione e, soprattutto, permette la valutazione della vascolarizzazione con colour Doppler. Nello scroto acuto l'ecografista spesso verrà chiamato a escludere patologie che richiedono un trattamento chirurgico, in particolare la torsione del funicolo spermatico. Al fine di fornire una valutazione precisa è tenuto ad avere una conoscenza dell'anatomia scrotale, della tecnica ecografica e a conoscere le varie patologie. Questo articolo di revisione ha lo scopo di familiarizzare il lettore con gli aspetti ecografici della patologia scrotale acuta più frequente.

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Section: Epididymitismentioning

confidence: 99%

A review of ultrasound imaging in scrotal emergencies

Yusuf

Sidhu

2013

J Ultrasound

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“…Orchitis and orchiepididymitis present with acute symptoms, such as pain and swelling [9]. Most of the times the etiology is bacterial, but can also be fungal [10].…”

Section: Inflammatory and Infectious Scrotal Lesionsmentioning

confidence: 99%

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

et al. 2016

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Conventional ultrasonographic evaluation (grey scale and Doppler) represents the first line investigation in the acute pathology of the scrotum. Its diagnosis value in acute scrotal pathology is undoubted in regard with hypervascular lesions, but in the evaluation of isoechoic and hypo/avascular lesions i.v. contrast-enhanced harmonic ultrasonography (CEUS) is recommended in establishing a firm and certain diagnosis. Besides these, CEUS has an important role in the evaluation of the remaining viable testicular tissue in cases of testicular trauma, thus guiding a limited excision surgery. This paper aims to discuss the added diagnosis value of CEUS and to illustrate this through various ultrasonographic images suggestive for acute scrotum pathology.

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“…Epididymitis is ranked as the fifth most common male urological condition in men of reproductive age (Collins et al ., ; Turner, ), with an incidence rate of 25–32/10,000 person‐years in its acute form in the UK alone (Nicholson et al ., ). In the US, there are at least 600,000 outpatient clinic visits every year with epididymitis as a presenting clinical condition (Krieger, ).…”

Section: Epididymitismentioning

confidence: 97%

In search of new paradigms for epididymal health and disease: innate immunity, inflammatory mediators, and steroid hormones

et al. 2019

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The primary job of the epididymis is to mature and protect the luminally transiting spermatozoa. Mounting evidence is showing that innate immune components [including Toll‐like receptors (TLRs) and antimicrobial proteins, among which are β‐defensins] and inflammatory mediators, under the primary influence of androgens, participate in the cellular and molecular processes that define this tissue. Here, we present an overview of the contributions of these signaling pathway components during epididymal homeostasis and discuss the hypotheses as to their involvement in epididymitis, the most common urological inflammatory condition in men, frequently impairing their fertility. Drawing primarily from rodent models, we also focus on how the distribution and functional expression of innate immune components are differentially regulated in the prenatal developing epididymis, providing new insights into the disruption of these signaling pathways throughout the lifespan. Male infertility is caused by a variety of conditions, such as congenital malformations, genetic and endocrine disorders, exposure to environmental toxicants, and inflammatory/infectious conditions. More than one‐third of infertile men with an idiopathic condition cannot currently be adequately diagnosed. Thinking about the innate immunity and inflammation context of the epididymis may provide new insights and directions as to how these systems contribute to male fertility, as well as also uncover urological and andrological outcomes that may aid clinicians in diagnosing and preventing epididymal pathologies.

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Management of epididymo-orchitis in primary care: results from a large UK primary care database

Cited by 58 publications

References 23 publications

A review of ultrasound imaging in scrotal emergencies

A review of ultrasound imaging in scrotal emergencies

Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay.

In search of new paradigms for epididymal health and disease: innate immunity, inflammatory mediators, and steroid hormones

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