Epididymitis is called inflammation of the epididymis epididymis. Annually, this disease is recorded in 600,000 men aged 18 to 35 years. Most often, epididymitis provokes sexually transmitted infections - gonorrhea and chlamydia. However, since the appendages of the testis are connected to the urethra, the infection can enter the body in another way, for example, together with E. coli. Epididymitis leads to swelling of the scrotum, so most often a man begins to think that he has a hernia, but this diagnosis excludes the accompanying acute pain. To find out if you have epididymitis and how to deal with it, read this article.
Quick facts
- Epididymitis is an inflammation of the epididymis, a cork near the testicles that stores and transfers sperm.
- Epididymitis in adults is most often caused by gonorrhea or chlamydia, while epididymitis in children is probably caused by direct trauma or urinary tract infection (UTI).
- Complications are rare, but may include infertility and death of testicular tissue.
Epididymitis is an inflammation of the appendage. Epididymis is a tube located at the back of the testicles that stores and transfers sperm. When this tube becomes swollen, it can cause pain and swelling in the testicles.
Epididymitis can affect men of all ages, but it is most common in men aged 14 to 35 years. This is usually caused by a bacterial infection or sexually transmitted disease (STD). The condition usually improves with antibiotics.
Acute epididymitis lasts six weeks or less. In most cases of acute epididymitis, the testes also become inflamed. This condition is called epididymo-orchitis. It is difficult to say whether the testicles, epididymis, or both are inflamed. This is why the term epididymo-orchitis is commonly used. According to the Centers for Disease Control and Prevention (CDC), gonorrhea and chlamydia are the most common causes in men 35 years of age or younger.
Chronic epididymitis, on the other hand, lasts six weeks or more. Symptoms include discomfort or pain in the scrotum, epididymis or testicles. This can be caused by granulomatous reactions, which can lead to the formation of cysts or calcifications.
What are the symptoms of epididymitis?
Epididymitis may begin with a few minor symptoms. However, when it remains untreated, the symptoms tend to worsen.
People with epididymitis may experience:
- low grade fever
- chills
- pelvic pain
- testicular pressure
- pain and tenderness in the testicles
- redness and warmth in the scrotum
- enlarged lymph nodes in the groin
- pain during intercourse and ejaculation
- pain during urination or bowel movements
- urgent and frequent urination
- abnormal penile discharge
- blood in semen
Who is at risk for developing epididymitis?
The most common cause of epididymitis is an STI, especially gonorrhea and chlamydia. However, epididymitis can also be caused by an infection that is transmitted without infection, such as a urinary tract infection (UTI) or a prostate infection.
You may have an increased risk of developing epididymitis if you:
- uncircumcised
- have unprotected sex
- have structural problems in the urinary tract
- have tuberculosis (TB)
- have an enlarged prostate causing blockage in the bladder
- An operation on the urinary tract has recently been performed.
- recently experienced groin damage
- use urinary catheter
- use a cardiac drug called amiodarone
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STIs are a common cause of epididymitis. Gonorrhea and chlamydia are the most common. These infections will cause an infection in the urethra. These infections will sometimes travel along the vas deferens to the epididymis or testicles to cause infection there.
Infinitely transmitted infections, such as those coming from UTI or tuberculosis, can travel from the urethra or other parts of the body to infect or cause inflammation of the appendage.
Epididymitis in children
Pediatric epididymitis
Children can get epididymitis just as adults can, although inflammation is more likely to have a different cause.
Common causes of epididymitis in children include:
- direct injury
- UTIs that spread to the urethra and epididymis
- urine reflux in epididymis
- torsion or twisting of the epididymis
Symptoms of epididymitis in children include:
- urethral discharge
- discomfort in the pelvis or lower abdomen
- pain or burning while urinating
- redness or tenderness of the scrotum
- fever
Treatment for pediatric epididymitis will depend on the underlying cause of the disease. For many reasons, the condition can be resolved on its own, with the help of rest and painkillers such as ibuprofen. With a bacterial infection similar to that of UTI, antibiotics can be prescribed. Children are also advised to avoid “holding it” when they need to use the bathroom and drink more water.
How is epididymitis diagnosed?
Your doctor will first complete a physical examination. They will look for testicular edema, swelling of the lymph nodes in the groin area and abnormal ejection from the penis. If you have discharge, your doctor will use a cotton swab to collect the sample and check for STIs.
Your doctor may also perform the following tests and procedures:
- rectal examination, which can show if the enlarged prostate caused your condition
- blood tests such as CBC (complete blood count) to determine if there is an infection in your system
- a urine sample that can indicate if you have a urinary tract infection or STI
. Image testing can be done to rule out other conditions. These tests provide detailed images that allow your doctor to clearly see structures in the body. Your doctor may order an ultrasound test on a testicle to get images of the testicles and surrounding tissue in the scrotum.
How is epididymitis treated?
Treatment for epididymitis includes treatment for underlying infection and amelioration of symptoms.
Common treatments include:
- antibiotics that are administered for 4-6 weeks in chronic epididymitis and may include painkillers doxycycline and ciprofloxacin
- that may be available over the counter (ibuprofen) or may require a prescription (codeine or morphine)
- anti-inflammatory drugs such as piroxicam (Velden) or ketorolac (Toradol)
- bed rest
Additional procedures may include:
- scrotum elevation for at least two days if possible
- applying cold packs to the scrotum
- in a sports cup to support
- avoiding lifting heavy objects
In the case of STIs, you and your partner should refrain from intercourse until you have completed your course of antibiotics and are completely cured.
These methods are usually successful. Sometimes it may take several weeks for the soreness or discomfort to completely disappear. Most cases of epididymitis are resolved within 3 months. However, in some cases, a more invasive treatment may be required.
If an abscess develops on your testicles, your doctor may drain pus with a needle or with surgery.
Surgery is another option if other treatments have not been successful. This includes the removal of all or part of the epididymis. Surgery may also be required to repair any physical defects that may cause epididymitis.
Epididymitis Prevention
To avoid the disease epididymitis, you must selectively treat your sex life and more carefully choose your sexual partners.
The best prevention of this diagnosis is one sexual partner who underwent a complete examination for sexually transmitted diseases and other infections.
Among the other methods of reliable prevention of epididymitis, it is worth highlighting:
- mumps vaccination
- abstinence from sex,
- monogamy
- barrier contraception
- personal hygiene
- regular visit to the urologist.
If you follow these simple rules, you can protect the body and the genitourinary system from extremely undesirable infections with possible complications for male strength and health.
The prognosis and complications of epididymitis
If the patient timely detected the development of epididymitis in the body and passed a successful course of antibacterial therapy, then we can judge the final recovery. After the start of taking antibiotics, the pain disappears after a couple of days, but if this does not happen, you need to change the treatment regimen.
The prognosis is disappointing in the diagnosis of chronic epididymitis, moreover, serious health complications are not ruled out. It could be:
- infertility (in the case of bilateral epididymitis),
- sepsis (blood poisoning),
- Fournier gangrene (destruction of scrotum cells),
- orchoepididymitis.
The longer you ignore the problem, the higher the risk and threat to health. In the most neglected clinical pictures, blood poisoning and death of the patient are not excluded. Therefore, it is recommended for characteristic symptoms to seek the advice of a narrow specialist - a urologist.
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Read about a common illness like hepatitis b. Know which side this infection can get.And here answers to all questions about torsion of testis hydatide in children are disclosed.
What is the prospect for someone with epididymitis?
Most cases of acute epididymitis are successfully treated with antibiotics. Usually there are no prolonged sexual or reproductive problems. But the infection may return in the future. It is also possible for complications, but it is rare.
Possible complications include:
- chronic epididymitis
- testicular shrinkage
- fistula, or abnormal passage, into the scrotum
- testis death
- infertility
It is important to seek immediately to prevent complications. Once you receive treatment, it is important that you complete the entire course of antibiotics to treat the infection, even if you do not feel the symptom. You should also see your doctor after you have completed treatment to make sure the infection is clear. This will help ensure full recovery.
If you experience constant pain or discomfort, make an appointment with your doctor, especially if the symptoms do not improve within four days. If you experience severe pain in the scrotum or have a fever, consult a doctor immediately.
