Testicular Disorders

Acute Epididymitis

  • result of descending infection caused by urinary tract pathogens
  • When the infection involves the epididymis and testis (epididymo-orchitis), sonography will frequently show an
    enlarged heterogeneous testis with increased color flow.
  • In sexually active men under age 35, acute epididymitis is caused most frequently by Chlamydia trachomatis and less commonly by Neisseria gonorrhoeae.
  • Clinical features suggestive of urethritis may be absent (subclinical urethritis). Epididymitis in men who have practiced unprotected insertive rectal intercourse is often caused by Enterobacteriaceae.
  • These men usually do not have urethritis but do have bacteriuria. Treatment of acute epididymo-orchitis consists of administering appropriate antibiotics for the treatment of both gonorrhea and Chlamydia infections. 

Testicular Torsion

  • Unilateral absent flow on color and spectral Doppler sonography is a highly sensitive and specific finding
  • Heterogeneous echotexture of the testis is a common finding in sonograms performed to evaluate acute scrotal pain, regardless of the cause.
  • emergent urology referral is indicated

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