General Guideline Principles for Epididymo-Orchitis
for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Epididymo-Orchitis.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Introduction of Epididymo-Orchitis

Infectious causes account for the great majority of instances of epididymitis or combination epididymitoorchitis. It is possible that this entity occasionally represents an occupational sickness or injury outside of the obvious setting of direct work-related trauma because a small but significant minority of patients report a history of a heavy lift or strain that caused the symptoms.

A urologist should assess patients with a clinical course that does not improve. Patients should be checked for tumours, genitourinary infections, and testicular torsion (a surgical emergency). Anyone who has proof of any of these illnesses should be referred to an Urologist or primary healthcare physician.

Medications of Epididymo-Orchitis

Ibuprofen, naproxen, or other NSAIDs from an earlier generation are suggested as first-line treatments for the majority of patients. For patients who are not candidates for NSAIDs, acetaminophen (or the analogue paracetamol) may be a viable alternative, even if the majority of research indicates it is just marginally less effective than NSAIDs.

There is proof that NSAIDs are less dangerous and just as effective in treating pain as opioids, such as tramadol.

1. Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

   Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are recommended in order to treat epididymo-orchitis.

   Indications – For the treatment of epididymo-orchitis, NSAIDs are advised. First, try over-the-counter (OTC) medications to see whether they work.

   Frequency/Duration – Many patients could find it reasonable to use as needed.

   Indications for Discontinuation – Epididymoorchitis healing, lack of effectiveness, or emergence of unfavourable consequences requiring termination.

    

2. NSAIDs for Patients at High Risk of Gastrointestinal Bleeding

   NSAIDs for Patients at High Risk of Gastrointestinal Bleeding is recommended Misoprostol, sucralfate, histamine Type 2 receptor blockers, and proton pump inhibitors are commonly used together by individuals who are at high risk of gastrointestinal bleeding.

   Indications – Cytoprotective drugs should be taken into consideration for patients with a high-risk factor profile who also have indications for NSAIDs, especially if a prolonged course of treatment is planned. Patients who have a history of gastrointestinal bleeding in the past, the elderly, diabetics, and smokers are at risk.

   Frequency/Dose/Duration – H2 blockers, misoprostol, sucralfate, and proton pump inhibitors are advised. dosage recommendations from the manufacturer. It is generally accepted that there are no significant differences in effectiveness for preventing gastrointestinal bleeding.

   Indications for Discontinuation – Intolerance, the emergence of negative effects, or the stopping of NSAIDs.

    

3. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

   The advantages and disadvantages of NSAID therapy for pain should be explored with patients who have a history of cardiovascular disease or who have several cardiovascular risk factors.

    

   • NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

     NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended as far as cardiovascular side effects go, acetaminophen or aspirin as first-line medication seem to be the safest options. If necessary, non-selective NSAIDs are recommended to COX-2-specific medications.

     To reduce the chance that an NSAID will negate the protective effects of low-dose aspirin in individuals receiving it for primary or secondary cardiovascular disease prevention, the NSAID should be taken at least 30 minutes after or eight hours before the daily aspirin.

      

4. Acetaminophen of Epididymo-Orchitis

   Acetaminophen of Epididymo-Orchitis is recommended for the treatment of epididymo-orchitis, especially in patients who have NSAID contraindications.

   Indications – Epididymo-orchitis pain in all patients, including those with acute, subacute, chronic, and post-operative pain.

   Dose/Frequency – As per the manufacturer’s recommendations; can be used as required. Over four gm/day, there is evidence of liver toxicity.

   Indications for Discontinuation – pain, side effects, or intolerance are gone.

Treatments of Epididymo-Orchitis

1. Rehabilitation

   Rehabilitation is not recommended in order to treat epididymo-orchitis.

    

2. Bed Rest

   Bed Rest of Epididymo-Orchitis is not recommended for the treatment of either epididymo-orchitis or epididymitis.

    

3. Ice or Intermittent Elevation

   Ice or Intermittent Elevation is not recommended for the treatment of either epididymo-orchitis or epididymitis.

What our office can do if you have workers compensation related Epididymo-Orchitis.

As orthopaedic surgeons, we do not treat this condition. A urologist should assess patients with Epididymo-Orchitis.

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.