Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1986 September; 79(9): 515–519.
PMCID: PMC1290455

Fate of the testis following epididymitis: a clinical and ultrasound study.


The progress of 33 men suffering from acute epididymitis, the majority of whom were treated as hospital inpatients, was prospectively monitored in order to determine the incidence of complications, and to assess the prognostic implications of clinical and scrotal ultrasound features found at initial presentation. Serious testicular complications resulting in frank infarction, suppurative necrosis and late atrophy developed in 39%. Three factors were shown to have significant discriminant value in predicting an adverse outcome: severe degree of inflammation with induration of the spermatic cord; the presence of a coexistent bacterial urinary infection; and a uniformly reduced testicular echo pattern on the affected side as visualized on ultrasound. A more aggressive approach in addition to medical measures appears to be indicated in these patients. The rationale of early surgical decompression by epididymotomy and spermatic fasciotomy is discussed. Scrotal ultrasound should be considered as a routine investigation in the management of epididymitis.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cass AS, Cass BP, Veeraraghavan K. Immediate exploration of the unilateral acute scrotum in young male subjects. J Urol. 1980 Dec;124(6):829–832. [PubMed]
  • GARTMAN E. Epididymitis. A reappraisal. Am J Surg. 1961 Jun;101:736–741. [PubMed]
  • Mittemeyer BT, Lennox KW, Borski AA. Epididymitis: a review of 610 cases. J Urol. 1966 Mar;95(3):390–392. [PubMed]
  • Witherington R, Harper WM., 4th The surgical management of acute bacterial epididymitis with emphasis on epididymotomy. J Urol. 1982 Oct;128(4):722–725. [PubMed]
  • Kirk D, Gingell JC, Feneley RC. Infarction of the testis: a complication of epididymitis. Br J Urol. 1982 Jun;54(3):311–312. [PubMed]
  • Bird K, Rosenfield AT. Testicular infarction secondary to acute inflammatory disease: demonstration by B-scan ultrasound. Radiology. 1984 Sep;152(3):785–788. [PubMed]
  • Nilsson S, Obrant KO, Persson PS. Changes in the testis parenchyma caused by acute nonspecific epididymitis. Fertil Steril. 1968 Sep-Oct;19(5):748–757. [PubMed]
  • Vordermark JS, 2nd, Buck AS, Brown SR, Tuttle WK., 3rd The testicular scan. Use in diagnosis and management of acute epididymitis. JAMA. 1981 Jun 26;245(24):2512–2514. [PubMed]
  • Vordermark JS, 2nd, Favila MQ. Testicular necrosis: a preventable complication of epididymitis. J Urol. 1982 Dec;128(6):1322–1324. [PubMed]
  • Desai KM, Haworth JM, Gingell JC. Scrotal ultrasound. J R Soc Med. 1985 Sep;78(9):710–714. [PMC free article] [PubMed]
  • Hourihane DO. Infected infarcts of the testis: a study of 18 cases preceded by pyogenic epididymoorchitis. J Clin Pathol. 1970 Nov;23(8):668–675. [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press