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Epididymo-orchitis
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== Pathophysiology == * Infection reaches epididymis via the vas from a primary infection of the urethra, prostate or seminal vesicles * Younger men: STI - commonly chlamydia or gonococcal * Older men: UTI or IDC-related * Blood-borne may be possible - how else would it happen in post-vasectomy men? * Infection usually starts in the tail then spreads to the rest, and occasionally the testis * Tuberculous - usually affects lower pole first ** Typically firm, uncomfortable discrete swelling of lower pole of epididymis ** Progression to entire epididymis feeling firm and craggy with normal testis ** Lax secondary hydrocoele in 30% ** Characteristic beading of vas - subepithelial tubercles
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