Epididymitis

What Is Epididymitis?

Epididymitis is a pathological condition in which there is inflammation of the epididymis which is situated at the back of the testicle and its function is to store and carry sperms. Epididymitis can develop in any individual irrespective of the age. This condition is most often than not caused by bacterial infection which can be transmitted through unprotected sexual activity like gonorrheal or chlamydial infections.

What Are The Causes Of Epididymitis?

Some of the causes of Epididymitis are:

Sexually Transmitted Infections: Gonorrhea and Chlamydia are the bacteria responsible for Epididymitis due to sexually transmitted infections. This by far the most common cause of Epididymitis in young males, although it may also develop in older aged male who are sexually active.

Epididymitis Caused By Other Infections: For males who are not sexually active, this disease can be caused by bacterial infections because of a urinary tract infection or infection of the prostate through which the bacteria might enter the epididymis and cause Epididymitis.

Epididymitis Caused By Medications: A medication usually used for cardiac conditions called amiodarone when given in high dosages tends to cause Epididymitis.

Chemical Epididymitis: This condition develops when there is a backflow of the urine into the epididymis. This can occur because of heavy lifting or strenuous activity.

Epididymitis Caused By Trauma: Epididymitis can also be caused due to some sort of injury in the groin region like being hit by a ball or being assaulted affecting epididymis resulting in development of Epididymitis.

Tuberculosis: It may be rare but bacteria which are responsible for causing diseases like tuberculosis can sometimes affect the epididymis and cause Epididymitis.

What Are The Risk Factors For Developing Epididymitis?

Some of the risk factors for developing Epididymitis are:

  • Unprotected sex or having sex with a partner who has a history of sexually transmitted infections, having a personal history of sexually transmitted disease
  • Having a history of infections to the urinary tract or the prostate
  • Having a history of surgical procedure to the urinary tract with insertion of catheters and other medical instruments
  • An individual with an uncircumcised penis has a high risk of developing Epididymitis
  • If an individual has prostate enlargement then it predisposes that individual to Epididymitis.

What Are Some Of The Symptoms Of Epididymitis?

Some of the symptoms of Epididymitis are:

  • Reddish discoloration of the scrotum
  • Warmth in the scrotal area
  • Testicular pain and tenderness, either unilaterally or bilaterally
  • Pain with urination
  • Increased frequency and urgency
  • Discharge from penis
  • Pain with sexual intercourse
  • Testicular lumps
  • Enlargement of lymph nodes in the groin area
  • Lower abdominal or pelvic pain
  • Blood in semen
  • Low grade fever.

Symptoms Of Epididymitis

How Is Epididymitis Diagnosed?

To begin with the treating physician will start by conducting a detailed examination of the groin area to look for any lymph node enlargement. Then the treating physician will check the scrotal and testicular areas to look for any swelling of the testicles. The treating physician may also perform a digital rectal examination to palpate the prostate to identify any tenderness or enlargement of the prostate. The next step towards diagnosis is to conduct diagnostic tests to include:

Screening For Sexually Transmitted Infection: To do this, the physician will obtain a specimen of the discharge from the urethra and send it to the laboratory for a thorough analysis to look for bacteria like gonorrhea and chlamydia.

Urinalysis And Blood Tests: This is done to look for any infections in the blood or urine causing the symptoms.

Ultrasound: This study is done to look at the blood flow to the testicles. If the blood flow is lower than what it needs to be then it is a case of testicular torsion and if it is higher than what it should be then it is a confirmed case of Epididymitis.

Treatment And Recovery Period Of Epididymitis

The frontline treatment for bacterial Epididymitis is antibiotics. The choice of antibiotics depends on the response of the affected individual towards treatment with certain classes of antibiotics. If the physician feels that the recovery is not adequate then the antibiotics might be changed. In cases of infection being caused by sexually transmitted infections then the partner of the affected individual may also need to be checked and treated appropriately. It is imperative for the affected individual to take the prescribed course of antibiotics diligently even if the individual has symptom relief until the physician asks to stop the medication when the infection has completely cleared.

The symptoms might go away in a few days but the tenderness present in the area will take a few weeks to completely disappear. The affected individual needs to take adequate rest, elevate the scrotal area with a pillow or a pad supporting, and apply ice pack and take pain medication for symptom relief while the infection clears.

It is imperative that the affected individual goes for regular followups during the entire course of treatment to make sure that the infection has cleared up entirely. If there are still traces of infection then the physician may prescribe a stronger antibiotic. Majority of cases of Epididymitis takes approximately three months to completely clear. Some recent studies suggest that treatment may not be required for young boys who have not attained puberty as this condition is quite common and heals on its own.

Surgical Treatment: If cases where there is formation of an abscess then a surgical procedure might be required in order to drain the abscess. In some cases the affected individual may require complete or partial removal of the epididymis.

Tips To Cope With Epididymitis

Epididymitis is a condition which can cause a lot of pain and discomfort. Therefore, to relieve pain and discomfort the following steps can be taken:

  • Adequate rest while the treatment is going on
  • Try and keep the scrotal area elevated to ease the discomfort
  • Apply cold packs for 15-20 minutes two to three times a day to the affected area to reduce swelling and inflammation and to ease pain
  • Wear athletic supporters to support the scrotum
  • Abstain from lifting heavy articles or perform any strenuous activity
  • Abstain from sexual intercourse until the physician gives the okay to do so after the infection has completely healed.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: April 5, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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