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Treatment

The treatment of acute epididymo-orchitis is mostly conservative. Even though it is often not possible to identify any infecting organism within the genital or urinary tracts, it is still best to treat patients with epididymo-orchitis with a full course of antibiotics. A broad spectrum antibiotic is initially used. This can be modified if subsequent bacteriological studies of the urine, or of a urethral swab identify an organism and thereby prompt a more specific antibiotic therapy. Allied with this antibiotic therapy should be bed rest, analgesics and, if or when the patient is mobile, an appropriate scrotal support. In severe cases, a patient may need to be admitted for general nursing care and intravenous antibiotics. In those rare instances where an abscess forms, this should be drained by surgical incision in the area of the scrotum where this abscess ‘points’. This is usually shown by a necrotic area of skin in the midst of the inflamed scrotum. In patients with chronic epididymoorchitis or in whom a cold abscess (that is, without pain, tenderness or fever) presents, additional microbial studies for tuberculosis should be performed.