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Infections: Orchitis, & Epididymitis
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===Management=== *'''General principles of therapy include bed rest, scrotal support, hydration, antipyretics, anti-inflammatory agents, and analgesics.''' **'''Treatment of chronic orchitis or orchialgia is supportive.''' Anti-inflammatory agents, analgesics, support, heat therapies, and nerve blocks all have a role in ameliorating symptoms. *'''Antibiotic therapy (specific for UTIs, prostatitis, or sexually transmitted diseases) should be employed for infectious orchitis''' **If early testing findings are negative or results are unavailable, empirical treatment should be initiated, directed at the most likely pathogens based on the available clinical information; '''a fluoroquinolone would be the best agent in this scenario.''' **'''Orchitis resulting from Mycobacterium tuberculosis infection requires treatment with antituberculous drugs (rifampin, isoniazid, and pyrazinamide or ethambutol)''' and rarely surgery. **'''There are no specific anti-viral agents available to treat orchitis caused by mumps''', and the previously mentioned supportive measures are important. **Abscess formation is rare; if it does occur, then percutaneous or open drainage is necessary *'''Spermatic cord blocks with injection of a local anesthetic''' may sometimes be needed to relieve severe pain. *Surgical intervention is rarely indicated, unless testicular torsion (or rarely xanthogranulomatous orchitis) is suspected; orchidectomy is indicated only in cases in which pain control is refractory to all other measures (and even this might not be successful in alleviating the chronic pain)
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