Therapeutic target
- Freedom from symptoms
- Avoidance of complications
Therapy recommendations
- Bed rest; cooling and elevation of the testicle.
- Analgesia (analgesics/painkillers) including cooling of the testicle.
- Inflammatory (anti-inflammatory) therapy (e.g., non-steroidal anti-inflammatory drugs (NSAIDs); also glucocorticoids, if necessary).
- Acute orchitis (testicular inflammation).
- Bacterial orchitis: specific antibiosis (antibiotic therapy depending on age groups, men who have sex with men (MSM) – if possible after resistance determination.
- Viral orchitis: symptomatic therapy; to prevent bacterial superinfection and possible abscessation, antibiotics are also administered
- Testicular involvement in systemic autoimmune diseases: high-dose glucocorticosteroids.
- Acute epididymitis (AE; epididymitis).
- Neisseria gonorrhoeae* : Ceftriaxone i. m. plus azithromycin or doxycycline.
- Chlamydia trachomatis* : Azithromycin/erythromycin or ofloxacin.
- Enterobacteriaceae: Ofloxacin or levofloxacin
Notice: Recurrent epididymitis is described in up to 20% of cases.
- Chronic epididymitis (CE): antimicrobial therapy based on resistance determination.