Epididimitis
Epididimitis
Epididimitis
EPIDIDIMITIS
HASNA IBADURRAHMI
12.065
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Sekilas basic . . .
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Epididimitis
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Faktor Risiko
Hubungan seksual dg > 1 pasangan dan tidak
use kondom
Belum disunat
Pasca operasi
Penggunaan kateter dalam jangka waktu lama
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Klasifikasi
Akut
Kronik
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Epididimitis Akut
Aktif berhubungan seksual men aged < 35
years
C. trachomatis or N. gonorrhoeae
< 6 minggu
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Epididimitis Kronik
Inadequate treatment of acute epididymitis
Recurrent epididymitis
Granulomatous reaction
Penyakit kronik
> 6 minggu
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Incidence
Epididymitis is most common in young men
ages 19-35
~1 in 1000 men develop epididymitis annually
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Epididymitis signs/symptoms
Heavy sensation in the
testicle area
Painful scrotal swelling
Fever
Testicle pain gets
worse with pressure
Lump in the testicle
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Epididymitis signs/symptoms
Blood in the semen
Discharge from the
urethra
Pain or burning during
urination or ejaculation
Discomfort in the
lower abdomen or
pelvis
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Epididymitis diagnosis
HPI
Physical exam
Additional tests:
Urinalysis
Pewarnaan gram
Kultur, nucleic acid hybridization tests, and
NAATs detection of both N. gonorrhoeae and
C. trachomatis
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Epididymitis treatment
Recommended Regimens:
Ceftriaxone 250mg IM in a single dose PLUS
Doxycycline 100mg PO BID x 10 days
For acute epididymitis most likely caused by enteric
organisms:
Levofloxacin 500mg PO once daily x 10 days
OR
Ofloxacin 300mg PO BID x 10 days
Source: Centers for Disease Control and Prevention (CDC). Epididymitis. In: Sexually transmitted
diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):67-9.
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Epididymitis complications
Complications of epididymitis:
Abscess in the scrotum
Chronic epididymitis
Fistula on the skin of the scrotum
(cutaneous scrotal fistula)
Death of testicular tissue due to lack of
blood (testicular infarction)
Sepsis & infertility
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Epididymitis prevention
Practicing safe sex
Treating sexual partners as a contact to
epididymitis
Repeat screening for STI ~ 2 months
after initial testing for re-infection
Abstain from sex until the individual &
sex partners have completed treatment
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References
Centers for Disease Control and Prevention (CDC). Epididymitis. In:
Sexually transmitted diseases treatment guidelines, 2010. MMWR
Recomm Rep. 2010 Dec 17;59(RR-12):67-9.
Nickel JC. Inflammatory Conditions of the Male GenitourinaryTract:
Prostatitis, and Related Conditions, Orchitis, Epididymitis. In: Wein
AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders
Elsevier; 2011:chap 11.
Trojian TH, Lishnak TS, Heiman D. American Family Physician. 2009
Apr 1;79(7):583-7. Epididymitis and orchitis: an overview.
Walker NA, Challacombe B. Practitioner. 2013 Apr;257(1760):21-5,
2-3. Managing epididymo-orchitis in general practice.
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