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Epididymitis
Introduction
Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Pain and swelling are the most common signs and symptoms. Males of any age can get epididymitis, but it's most common in men between the ages of 19 and 35.
Epididymitis is most often caused by a bacterial infection or by a sexually transmitted disease (STD) such as gonorrhea or chlamydia. In some cases, the testicle may also become inflamed — a condition called orchitis.
Signs And Symptoms
The signs and symptoms of epididymitis depend on the cause. They can include:
- A tender, swollen, red or warm scrotum.
- Testicle pain and tenderness, usually on one side — the pain may get worse when you have a bowel movement.
- Painful urination or an urgent or frequent need to urinate.
- Painful intercourse or ejaculation.
- Chills and a fever that can last up to six weeks.
- A lump on the testicle.
- Enlarged lymph nodes in the groin (inguinal nodes).
- Pain or discomfort in the lower abdomen or pelvic area.
- Discharge from the penis.
- Blood in the semen.
Signs and symptoms of epididymitis usually develop over a day or two and get better with treatment. In some cases, epididymitis may not clear up completely, or may recur. This is known as chronic epididymitis. Symptoms of chronic epididymitis may come on gradually. Sometimes the cause of chronic epididymitis is not identified.
Causes
Epididymitis has a number of causes, including:
- Sexually transmitted disease (STD). STDs, particularly gonorrhea and chlamydia, are the most common cause of epididymitis in young, sexually active men.
- Other infections. Boys, older men and homosexual men are more likely to have epididymitis caused by a non-sexually transmitted bacterial infection. For men who've had urinary tract infections or prostate infections, bacteria may spread from the infected site to the epididymis. Rarely, epididymitis is caused by a fungal infection.
- The heart medication amiodarone. In some cases, this anti-arrhythmic medication causes inflammation of the epididymis. Epididymitis caused by amiodarone is treated by reducing the dose of amiodarone or by changing medications.
- Tuberculosis. In some cases, tuberculosis can cause epididymitis.
- Urine in the epididymis. Known as chemical epididymitis, this occurs when urine flows backward into the epididymis. It most commonly occurs with heavy lifting or straining.
Epididymitis caused by a sexually transmitted disease (STD) or other infection is treated with antibiotic medications. Your sexual partner will also need treatment. Make sure your doctor is aware of any other medications you're taking or any allergies you have. This information, as well as determining what type of infection you have, will help your doctor select the best treatment.
Be sure to take the entire course of antibiotics prescribed by your doctor, even though you may get relief from your symptoms in two to three days after you start treatment. If you're not feeling better in that time, contact your doctor. When you've finished your medication, it's a good idea to return to your doctor for a follow-up visit to be sure that the infection has cleared up.
In most cases, symptoms improve after a few days of antibiotics. If your symptoms don't improve as expected, your doctor may try another antibiotic. If symptoms still don't improve, your doctor may do further tests to determine whether your epididymitis is caused by something other than a bacterial infection or STD.
If a pocket of pus (abscess) has formed, it may need to be drained, and in some cases part or all of the epididymis needs to be removed surgically. Surgery is sometimes necessary if epididymitis is due to underlying physical defects or if epididymitis is caused by tuberculosis.
Prevention
If your epididymitis was caused by an STD, your partner will also need treatment. If your partner doesn't get treatment, you may contract the STD again. Safer sexual practices, such as monogamous sex and condom use, help protect against STDs that can cause epididymitis.
If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor may discuss with you other ways to prevent epididymitis from recurring.
Information obtained from National Institute of Health