Free Module 10 · STIs and Urology

Epididymitis and orchiepididymitis associated with STIs

Author and medical review: Dr. Leonardo Romeo, urologist (physician) · Last updated:

1

Introduction

Learning objectives
  • Recognize when to consider sexually transmitted microorganisms in a patient with testicular pain.
  • Always prioritize excluding testicular torsion in an acute scrotum.
  • Understand why the diagnosis of epididymitis should not be assumed automatically in an adolescent or young adult.
2

Video lesson

▶
Video pending upload (embedded YouTube)
3

Summary

A sexually active patient may present with:

  • testicular pain;
  • swelling;
  • epididymal pain;
  • urinary symptoms;
  • urethral discharge.

In certain groups, especially young sexually active patients, sexually transmitted microorganisms should be considered, such as:

  • Chlamydia trachomatis;
  • Neisseria gonorrhoeae.

In other patients, urinary pathogens may predominate.

A priority

In any patient with acute scrotal pain, we must first consider the possibility of testicular torsion.

⚠️ Alert

We should not automatically diagnose "epididymitis" in an adolescent or young adult with acute testicular pain without considering torsion.

4

PDF

⬇ Download lesson summary

Downloadable PDF pending upload.

5

Practical algorithm

  1. Urethral discharge + dysuria → think of urethritis → gonococcus/Chlamydia among the main causes.
  2. Painless genital ulcer → consider syphilis.
  3. Painful vesicles or ulcers → consider genital herpes.
  4. Anogenital warts → consider HPV/condylomata.
  5. Epididymal pain in a sexually active patient → consider STIs depending on age and context, but rule out torsion in an acute scrotum.
  6. Diagnosis of an STI → consider testing for other STIs + partner management + prevention.
  7. Recent high-risk HIV exposure → promptly assess the indication for PEP.

An STI is not managed only by treating the patient. The approach includes correct diagnosis, screening for coinfections when appropriate, partner management and prevention of further transmission.

6

Clinical case

Content pending upload Progressive clinical case focused on decision-making.
7

Self-assessment

Questions pending upload 5–10 multiple-choice questions on this lesson.
8

References

Links pending upload References to PubMed, DOI, scientific society guidelines and journals.

Want us to let you know when this lesson is complete?

All set, we'll let you know! 🎉
← Back to program Next lesson: order to be determined

Related lessons

More lessons from Module 10 · STIs and Urology

Keep going