Complications
The overall rate of abscess formation is 3% to 8%.[38]
Prompt antibiotic treatment will reduce the risk of abscess formation and thus reduce the need for hospitalisation and surgery.
Surgical drainage may be required.
Occlusion of the testicular blood vessels, due to involvement of the cord in the inflammatory process or from extrinsic compression by the oedematous epididymis, can lead to ischaemia or infarction of the testis.
Subsequent testicular atrophy may result in problems with sub-fertility or infertility.
Prompt treatment and resolution of the local inflammation will help to prevent this rare complication.
If infection is inadequately treated, the inflammatory process will ultimately lead to scarring and obstruction of the epididymis. In the long term, this can result in sub-fertility or infertility.
The use of corticosteroids has not been shown to confer any significant benefit in reducing the risk of developing epididymal obstruction.[39]
The development of chronic pain following acute epididymitis is rare, and little is known about its aetiology and pathogenesis.[40]
Current management relies on reassurance and supportive treatment with analgesics, with epididymectomy considered only in extreme cases.
May be caused by surgery, obstruction, chronic inflammation, testicular ischaemia, or infarction. Treating epididymitis may result in the decrease of potential complications such as infertility. However, while treating infection may improve sperm quality, it does not necessarily improve the probability of increasing conception.[41]
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