Epididymal abscess

An epididymal abscess is an uncommon complication of epididymitis.

Causative organisms are the same that cause epididymitis:

  • older individuals
    • Escherichia coli
    • Proteus mirabills
  • younger individuals 
    • Chlamydia trachomatis
    • Neisseria gonorrhoeae
  • Other rare etiological agents
    • Streptococcus faecalls
    • Ureoplasma urealyticum
    • viral, spirochete infections
    • Mycobacterium tuberculosis (tuberculous epididymitis)

Sonographic findings include

  • scrotal wall thickening
  • hyperemic enlargement of the epididymis
  • focal regions of decreased or mixed echogenicity
  • nonvascular hypoechoic area surrounded with hypervascular epididymis

Tuberculous epididymal abscesses tend to be larger in size while the degree of blood flow in the peripheral portion of the abscess can be comparatively lower.

Further possible complications from an epididymal abscess

  • rupture with focal testicular ischemia or infarction
  • inflammatory ulceration of the efferent ductules or the ductus epididymis
    • may allow sperm to extravasate into the surrounding interstitium, inciting an intense inflammatory response that leads to sperm granuloma
      formation.
Ultrasound - testicular and scrotal
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Article information

rID: 23148
System: Urogenital
Synonyms or Alternate Spellings:
  • Epididymal abscesses
  • Pyogenic epididymal abscess
  • Pyogenic epididymal abscesses

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Cases and figures

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