What is the Difference Between Epididymitis and Testicular Torsion?

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Epididymitis and testicular torsion are two distinct conditions that can cause pain and discomfort in the scrotum. They share some similarities in presentation, which can make it challenging to differentiate between the two. Here are the main differences between the two conditions:

  1. Cause: Epididymitis is typically caused by an infection, such as a urinary tract infection or a sexually transmitted infection (STI). Testicular torsion occurs when the testicle has twisted and cut off its supply of blood, causing pain and discomfort.
  2. Onset of pain: The onset of testicular pain with epididymitis is usually gradual. In contrast, testicular torsion typically presents with a sudden onset of pain.
  3. Symptoms: Epididymitis is characterized by local swelling and tenderness of the scrotum, which may be accompanied by urethral discharge, dysuria, fever, and other symptoms. Testicular torsion, on the other hand, is associated with symptoms such as nausea, vomiting, abnormal cremasteric reflex, high position of the testis, and a positive Prehn's sign.
  4. Diagnostic tests: Diagnosis of epididymitis typically involves urine testing and ultrasound imaging of the scrotum. Testicular torsion may require more invasive diagnostic tests, such as color Doppler ultrasonography or testicular radionuclide scanning.
  5. Treatment: Epididymitis is usually treated with antibiotics and bed rest. Testicular torsion, however, is a surgical emergency, and immediate exploration is necessary to save the testicle.

It is crucial to consult a healthcare professional if you experience acute scrotal pain, as both epididymitis and testicular torsion require prompt diagnosis and treatment to minimize complications and ensure the best possible outcomes.

Comparative Table: Epididymitis vs Testicular Torsion

Epididymitis and testicular torsion are two different testicular conditions that can cause scrotal pain and swelling. Here is a table summarizing the differences between the two:

Feature Epididymitis Testicular Torsion
Definition Inflammation of the epididymis, a small coiled tube at the back of the testicle Rotating and twisting of the spermatic cord that provides blood flow to the testicles, leading to compromised blood flow and potential tissue death
Cause Often caused by infections, such as viral infections or refluxed urine No definitive cause, but it is believed to be related to abnormal anatomy, such as an extra-wide spermatic cord or testicles that are not fully descended
Symptoms Gradual onset of pain, local swelling and tenderness of the scrotum, urethral discharge, dysuria, fever, and chills Abrupt onset of pain, nausea, vomiting, and severe scrotal swelling
Age Group Most often affects men between 14 and 35 years of age Most often affects men between 12 and 18 years of age
Diagnosis Physical examination and imaging studies, such as ultrasound or computed tomography (CT) Physical examination, Doppler ultrasound, and sometimes surgical exploration if the diagnosis is unclear
Treatment Antibiotics for infection and symptom relief Emergency surgical exploration to determine the extent of tissue damage and preserve testicular function
Complications Chronic epididymitis, abscess formation, and reduced fertility Loss of testicular function, necrosis, and potential loss of the testicle if not treated promptly

It is essential to differentiate between these two conditions, as epididymitis can be treated with antibiotics, while testicular torsion requires emergency surgical intervention to preserve testicular function.