UroToday - Treatment

November 21, 2009

November 2009

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Infections

Epididymitis

Treatment

Empiric therapy is indicated before culture results are available
Treatment of epididymitis caused by C. trachomatis or N. gonorrhoeae will result in
- Microbiologic cure of infection
- Improvement of signs and symptoms
- Prevention of transmission to others
- A decrease in potential complications (e.g., infertility or chronic pain)
- As an adjunct to therapy, bed rest, scrotal elevation, and analgesics are recommended until fever and local inflammation have subsided.

Recommended Regimens

For epididymitis most likely caused by gonococcal or chlamydial infection:
Ceftriaxone 250 mg IM in a single dose
PLUS
Doxycycline 100 mg orally twice a day for 10 days

For epididymitis most likely caused by enteric organisms, for patients allergic to cephalosporins and/or tetracyclines, or for epididymitis in patients aged >35 years:
Ofloxacin 300 mg orally twice a day for 10 days
OR
Levofloxacin 500 mg orally once daily for 10 days

Follow-Up

Failure to improve within 3 days of the initiation of treatment requires reevaluation of both the diagnosis and therapy
Swelling and tenderness that persist after completion of antimicrobial therapy should be evaluated comprehensively The differential diagnosis includes tumor, abscess, infarction, testicular cancer, TB, and fungal epididymitis.

References

Reader Comments

Written by This email address is being protected from spam bots, you need Javascript enabled to view it on 2008-08-08 18:31:58

I appreciate any and all information related to this topic. I impatiently await the day something is discovered that will help me deal with my persistant pain.

Consultant Urologist
Written by This email address is being protected from spam bots, you need Javascript enabled to view it on 2007-10-21 01:50:40

Very good & informative.

MS. C.
Written by This email address is being protected from spam bots, you need Javascript enabled to view it on 2007-02-03 23:05:05

WHEN I WAS DIAGNOSED WITH I.C. 10 YEARS AGO I WAS GIVEN TEN AND A HALF MONTHS OF WEEKLY DMSO (RIMSO) INSTILLATIONS. I NOTICED MY EYESIGHT WAS BEING ADVERSLY AFFECTED DURING THIS TIME. AFTER MUCH RESEARCH THRU THE VETERINARY DEPT. AT UGA I WAS INFORMED THAT DMSO IS A SOLVENT THAT MAY ATTACK SOFT TISSUE AND THIS IN MY CASE IT WAS MY EYESIGHT. MY VISION WENT FROM 20/20 TO 20/95. I REALIZED AFTER MY RESEARCH THAT THESE TREATMENTS SHOULD HAVE BEEN DONE FOR NO MORE THAN 6 WEEKS BUT I WOULD LIKE TO ADVISE OTHER I.C. PATIENTS TO TAKE CAUTION AND DISCUSS THE POSSIBLE SIDE EFFECTS WITH THEIR UROLOGIST BEFORE PROCEEDING.

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