Testicular Infarction in the Presence of Epididymitis: An Anatomo Clinical Continuum?

Testicular Infarction in the Presence of Epididymitis: An Anatomo Clinical Continuum?

Epididymitis is an inflammation limited to the epididymis, common cause of acute scrotal pain and usually responsive to antibiotics, non-steroidal and anti-inflammatory drugs. Nevertheless complications such as orchitis and abscess may occur; a testicular infarction is less frequent. We are going to discuss two cases of segmental testicular infarction both associated with epididymitis. The first one developed in a massive hemorrhagic infarction after performing a not responsive homolateral epididymitis to conservative therapy and subsequent orchiectomy was performed. The second one was treated with successful medical therapy and complete restoration of testis. We reviewed the pertinent literature in terms of differential diagnosis, etiology with particular interest in physiopathological mechanisms of testicular infarction giving an original etiologic hypothesis.