Surg: Epididymo-Orchitis: Free MSRA Podcast

🍒 Epididymo-orchitis: Scrotal Pain & SwellingDemystified! 🚦Let’s get you ready to smash those MSRA questions.Here’s everythingyou need—clear, concise, and easy to remember. 💡 What is Epididymo-orchitis?Inflammation of epididymis and testisUsually infectious (bacterial most common)Key symptoms: scrotal pain, swelling, redness (usually one side) 🦠 Common CausesSTIs:  Chlamydia trachomatis & Neisseria gonorrhoeae (esp. <35 yrs)UTIs (older men, structural urinary issues)Mumps (post-pubertal males)TB (rare, but exam favourite)Iatrogenic: after urological procedures/cathetersDrugs: AmiodaroneImmunocompromised? Higher risk! ⚡️ Risk FactorsRisky sexual behaviour (unprotected sex)Previous STI or UTIUrinary tract abnormalitiesRecent instrumentation/catheterAge: 15–35 (STI) & >60 (UTI) 🧬 PathophysiologyAscending infection (urethra → epididymis → testis)Direct invasion → inflammation, pain, swellingLess commonly: blood-borne or viral spread 🔍 Differential Diagnosis (Don’t Miss!)Testicular torsion (sudden, severe pain—surgical emergency!)Trauma, tumour, abscess, hydrocele, varicoceleMnemonic:Torsion, Trauma,Tumour – must rule out! 📊 Epidemiology~1 in 1000 men/year (UK)Bimodal: 15–35 (STI), >60 (UTI/prostate)Mumps orchitis: up to 40% of post-pubertal mumps cases! 🤒 Clinical FeaturesGradual onset pain & swelling (vs torsion = sudden!)Tender, swollen epididymis/testis (often lower pole, unilateral)Red, hot scrotum+/- penile discharge (STI), dysuria, feverHydrocele, scrotal oedema 🧪 InvestigationsUrine dip/cultureNAAT for Chlamydia/GonorrhoeaUrethral swab (STI suspicion)Scrotal ultrasound (+Doppler: rule out torsion!)FBC, CRP, U&EConsider mumps, TB, HIV tests as indicated 💊 ManagementAntibiotics: - STI (young men): IM ceftriaxone + doxycycline  - UTI (older men): Ciprofloxacin/ofloxacin (based on culture)Pain relief: Paracetamol/NSAIDsScrotal support & restCold packs, elevationPartner notification/treatment (if STI)Follow-up: Ensure resolution, check for complications 🚩 ComplicationsAbscess (may need drainage)Chronic pain or swellingTesticular atrophyInfertility (esp. mumps/TB, severe or delayed cases)Sepsis (rare, serious) 🧠 Memory TipSCROTAL PAIN mnemonic:Swelling Causes Red flags (torsion)Orchitis Tests(urine, US) AntibioticsLover/partner notification Pain reliefAtrophy risk Investigations Need for follow-up 📚 MSRA Quick LinksRevision Notes:https://www.passthemsra.com/topic/epididymo-orchitis-revision-notes/Flashcards:https://www.passthemsra.com/topic/epididymo-orchitis-flashcards/Accordion Q&A:https://www.passthemsra.com/topic/epididymo-orchitis-accordion-qa-notes/Rapid Quiz:https://www.passthemsra.com/topic/epididymo-orchitis-rapid-quiz/Full Quiz:https://www.passthemsra.com/quizzes/epididymo-orchitis/Free resources:https://www.passthemsra.comhttps://www.freemsra.com 🏁 KEY TAKEAWAYSGradual scrotal pain/swelling? Think epididymo-orchitis!Always exclude torsion firstTreat early, follow up, educate on partner treatment #MSRA#EpididymoOrchitis #ScrotalPain #STI #UTI #Urology #GPExamPrep #PassTheMSRA#FreeMSRA 🚦🍒💊