Description

Epididymitis (ep-ih-did-uh-MY-tis) is an inflammation of the coiled tube called the epididymis, in the back of the testicle. The epididymis stores and carries sperm. Males of any age can get epididymitis.

Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (Stis), such as gonorrhea or chlamydia. Sometimes, a testicle is also inflamed — a condition called epididymo-orchitis.

Epididymitis is usually treated with antibiotics and measures to relieve the discomfort.

Symptoms

The symptoms of epididymitis may include:

  • A swollen, discolored or warm scrotum
  • Testicle pain and tenderness, usually on one side, which often comes in a slow way
  • Pain when passing urine
  • An urgent or frequent need to urinate
  • Discharge from the penis
  • Pain or discomfort in the lower abdomen or pelvic area
  • Blood in the semen
  • Less commonly, fever

Epididymitis chronic

Epididymitis that lasts more than six weeks, or happening again and again is considered chronic. The symptoms of epididymitis chronic may appear slowly. Sometimes, the cause of epididymitis chronic can't be found.

When to see a doctor

Do not ignore pain in the scrotum, or swelling. This can be caused by a number of conditions. Some of them need treatment right away to prevent permanent damage.

If you have severe pain in the scrotum, seek emergency treatment. If you have a discharge from their penis or pain when you pass urine, consult a health care provider.

Causes

Causes of epididymitis include:

  • Sti. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.
  • Other infections. The bacteria in the urinary tract or prostate infection can spread from the infected site to the epididymis. Also, viral infections, like the mumps virus, can result in epididymitis.
  • Urine into the epididymis. This condition occurs when urine flows backward into the epididymis, causing chemical irritation. It may be the result of heavy lifting or straining.
  • The Trauma. An injury to the groin can cause epididymitis.
  • Tuberculosis. Rarely, epididymitis can be caused by the infection of tuberculosis.

Risk factors

Certain sexual behaviors that can lead to sexually transmitted infections puts them at risk for sexually transmitted epididymitis, including:

  • Sex with a partner who has an STI
  • Sex without a condom
  • Anal Sex
  • A history of sexually transmitted infections

Risk factors for epididymitis that non-sexual transmission include:

  • Have a prostate or urinary tract infection
  • To have a medical procedure, a fact that affects the urinary tract, such as the insertion of a urinary catheter or the field in the penis
  • An uncircumcised penis
  • A difference in the typical anatomy of the urinary tract
  • The enlargement of the prostate, which increases the risk of bladder infections and epididymitis
  • Other health conditions that cause a weakening of the immune system, such as HIV

Complications

The complications of epididymitis include:

  • Infection with Pus, called an abscess, in the scrotum
  • Accumulation of fluid around the testicle, called a hydrocele
  • Epididymo-orchitis, if the condition extends from the epididymis to the testis
  • Rarely, the reduction of fertility

Prevention

To help protect against Stis that can cause epididymitis, the practice of safer sex.

If you have recurrent urinary tract infections or other risk factors for epididymitis, your doctor may talk with you about other ways you can help prevent the disease.

Diagnosis

For the diagnosis of epididymitis, your doctor may talk with you about your symptoms and examine your groin. This includes checking enlargement of the lymph nodes in the groin, and enlargement of the testicle on the affected side. Your provider may also do a rectal exam to check for prostate enlargement or tenderness.

Tests may include:

  • STIscreening. A narrow cotton swab is inserted into the end of your penis to collect a sample of any discharge that you may have. The sample is analyzed in the laboratory for gonorrhea and chlamydia.
  • Blood and urine samples. The samples of urine and blood can be sent to the lab for testing.
  • Ultrasound. This imaging test that uses sound waves to create images of your testicles. The test can show if you have testicular torsion. Testicular torsion is a twisting of the testicles that can cut off the flow of blood. If the ultrasound with color Doppler shows a lower blood flow to testis is usual, the testicle is twisted. If the blood flow is superior to typical, this can help to confirm that you have epididymitis.

Treatment

The treatment of epididymitis often includes antibiotics and comfort measures. Sometimes, surgery may be needed.

Antibiotics

Antibiotics are needed to treat bacterial epididymitis and epididymo-orchitis — epididymitis infection that has spread to a testicle. If the cause of the bacterial infection is a sexually transmitted infection , of any sex partners also need treatment. Take all antibiotics as prescribed by your doctor even if your symptoms go away before. This helps to ensure that the infection is gone.

Comfort measures

You should begin to feel better after 2 to 3 days on an antibiotic, but it can take several weeks for the pain and the swelling is gone. At rest, the support to the scrotum with an athletic supporter, apply ice packs and taking pain medication can help relieve the discomfort.

Your health care provider may want to see in a follow-up visit to check that the infection has gone away and the symptoms have improved.

Surgery

If an abscess has formed, you may need surgery to drain it. Sometimes, all or part of the epididymis should be removed surgically. This surgery is called an epididymectomy. Surgical repair can be performed when the underlying problems of the anatomy of the urinary tract lead to epididymitis.

Lifestyle and home remedies

Epididymitis often cause a lot of pain. Try these tips to ease your discomfort:

  • The bed rest.
  • Bedtime for the scrotum elevated.
  • Apply cold packs to the scrotum as tolerated.
  • Use a jock strap.
  • Avoid lifting heavy objects.
  • Avoid sexual intercourse until the infection has disappeared.

Preparing for your appointment

You may be referred to a specialist in urinary problems, which is called a urologist.

What you can do

Before your appointment, make a list of:

  • Your symptoms and when they began.
  • Key medical information, including previous sexually transmitted diseases or medical conditions and procedures.
  • All the drugs, vitamins, herbs, or other supplements you are taking, including the dosage. The dose is the amount of medication you take.
  • Questions to ask your health care provider.

Some questions to ask your health care provider include:

  • What is the most likely cause of my symptoms? There are other possible causes?
  • What tests do I need?
  • What treatments are recommended?
  • How long will it take for me to feel better?
  • If any of my mates to be tested for an STI ?
  • Should I restrict sexual activity during treatment?
  • I have other medical problems. How can I best treat together?

Do not hesitate to ask other questions that occur to you.

What to expect from your doctor

Your health care provider is likely to ask questions such as:

  • How bad are the symptoms? Are constant or come and go?
  • Nothing seems to make your symptoms better or worse?
  • Do you have discharge from the penis or of the blood in the semen?
  • Do you have pain when urinating or a frequent or urgent need to urinate?
  • Do you have pain during sex or when you ejaculate?
  • Have you or any sexual partner, or had been tested for an STI ?
  • Do your hobbies or work involving heavy lifting?
  • Have you been diagnosed with a condition of the prostate or urinary tract infection?
  • Have had surgery on or near the urinary tract, or surgery that requires the insertion of a catheter?
  • You have had an injury in the groin?

What you can do in the meantime

While you wait for your appointment, avoid sexual contact, and that can put a partner at risk of contracting an STI . This includes oral sex and skin-to-skin contact with the genitals.

Symptoms and treatment of Epididymitis