Acute epididymitis

Failure to improve within 3 days of commencing treatment should prompt reevaluation of the diagnosis and therapy. Persistence of symptoms may indicate abscess formation, testicular infarction, atypical infections (tubercular or fungal epididymitis), or underlying tumor.

Patients with a proven sexually transmitted infectious epididymitis should be referred for screening for other sexually transmitted diseases. The evaluation and treatment of all recent sexual partners is also essential to prevent reinfection. Protocols for partner notification vary by jurisdiction and as such practitioners should be aware of local policies in this regard.

In cases of nonsexually transmitted epididymitis caused by enteric pathogens, investigation for underlying lower urinary tract pathology should be considered once the patient has fully recovered.