Scrotal support and elevation
Cutaneous fistulization from rupture of an abscess through the tunica vaginalis (seen especially in tuberculosis)
Analgesics, including nerve blocks
Avoidance of urethral instrumentation
When treating epididymitis secondary to Chlamydia trachomatis or Neisseria gonorrhoeae, treatment of all sexual partners
Testicular infarction: Cord swelling can limit testicular artery blood flow
Reduction in physical activity
Epididymectomy: Typically reserved for refractory cases
Scrotal abscess and pyocele
Sitz baths
Orchiectomy: Indicated only for patients with unrelenting epididymal pain
Anti-inflammatory agents
Ice packs
Epididymotomy: Infrequently performed in patients with acute suppurative epididymitis
In chronic epididymitis, a 4- to 6-week trial of antibiotics effective against bacterial pathogens (especially chlamydiae)
Fertility problems
Recurrence, chronic epididymitis, and orchialgia
Skeletonization of the spermatic cord via subinguinal varicocelectomy: Performed in rare cases of refractory pain due to chronic epididymitis and orchialgia
Testicular atrophy
In prepubertal patients with epididymitis, antibiotic therapy only for young infants and those with pyuria or positive urine culture findings
