What is Epididymo-Orchitis: Causes, Symptoms, Treatment, Who is at Risk, Diagnosis
What is Epididymo-Orchitis?
Epididymo-Orchitis is a medical condition in which there is inflammation of the testicles and the epididymis. Epididymo-Orchitis is usually caused due to urinary tract infection or an infection that is transmitted due to inappropriate sexual practices. Epididymo-Orchitis is usually treated with a comprehensive course of antibiotics to eliminate the infection completely with complete recovery of the affected individual. Very rarely there may be some complications.
What are the Causes of Epididymo-Orchitis?
Majority of the cases of Epididymo-Orchitis are due to infection. These infections are caused by the following:
- Epididymo-Orchitis Caused By Urinary Tract Infection: Some bacteria like the E. coli which causes urine infections at times get to the vas deferens and lead to development of Epididymo-Orchitis. This is usually seen in men who are above the age of 35, as with age blockage of urine starts either due to enlargement of prostate or urethral stricture. When there is blockage of urine, it predisposes that individual to urine infections. A urine infection is also the most common cause of Epididymo-Orchitis in young boys.
- Epididymo-Orchitis Caused By Infection Due to Inappropriate Sexual Behavior: This is by far one of the most common causes of Epididymo-Orchitis in the young population but that does not mean that it does not occur in older sexually active men. Epididymo-Orchitis usually occurs with infections caused by bacteria gonorrhea and chlamydia. These infections affect the urethra causing urethritis and can also go down the vas deferens to the epididymis and testis causing Epididymo-Orchitis.
- Epididymo-Orchitis Caused By Mumps Virus: The mumps virus is also known to be one of the causes of Epididymo-Orchitis. This virus gets to the testes through the blood and causes the infection. This cause is now quite rare as most people are now vaccinated against this virus.
- Surgical Procedure to the Prostate and/or Urethra: A surgical procedure to the urethra may predispose the individual to bacterial infections causing Epididymo-Orchitis due to insertion of medical instruments and catheters. Epididymo-Orchitis at one time was a usual complication of prostatectomy but with advancement of techniques used for this surgery it has become rare.
- Epididymo-Orchitis Caused By Medication: Epididymo-Orchitis at times is also caused by a medication called amiodarone if taken at a relatively high dose.
Some of the other rare causes of Epididymo-Orchitis are viral infections to other parts of the body which affects the testes via the blood. Some of these infections are tuberculosis and brucellosis. This is generally true for people who have a compromised immune system.
Who is at Risk for Developing Epididymo-Orchitis?
Studies suggest that 1 out of every 1000 male suffers from Epididymo-Orchitis due to one reason or the other. Epididymo-Orchitis is usually seen in people between the age range of 15 and 30. It is also seen in men above the age of 60 who also suffer from diseases like urethral structure. Epididymo-Orchitis usually develops after attaining puberty. Approximately 30% of boys who have had mumps after puberty tend to develop Epididymo-Orchitis. The risk for developing Epididymo-Orchitis also increases if an individual has had a surgical procedure and has had medical instruments like catheters inserted.
What are the Symptoms of Epididymo-Orchitis?
Symptoms due to Epididymo-Orchitis tend to develop quickly. The individual suffering from Epididymo-Orchitis will have symptoms of epididymal and testicular swelling along with enlargement of the scrotum which will also have tenderness and will have a reddish discoloration. There is also severe pain in the scrotal area experienced. An individual may also experience other symptoms, especially if the condition is caused by some other infection, like difficulty with urination, penile discharge, fever, and a general sense of feeling unwell.
How is Epididymo-Orchitis Diagnosed?
To begin with, the treating physician will conduct a detailed examination of the penis and scrotum. The physician may also conduct a rectal examination to examine the prostate looking for any enlargement. The physician will then take a detailed history to determine if there has been any history of unsafe sexual activity which may have caused the symptoms. Additionally, the physician will perform the following tests:
- Laboratory Tests: Routine blood and urine tests will be done looking for any infection that may be causing the symptoms. In case of a penile discharge, a specimen of the discharge will be taken and sent to laboratory for thorough analysis.
- Ultrasound: An ultrasound of the scrotal areas will be done to look for inflammation which will clearly confirm the presence of Epididymo-Orchitis.
What is the Treatment for Epididymo-Orchitis?
The frontline treatment for Epididymo-Orchitis is a comprehensive course of antibiotics, which usually resolves the condition. The pain associated with Epididymo-Orchitis generally subsides within a few days. It may take a few weeks for the swelling to resolve. The antibiotic chosen will depend on the response of the individual to the prescribed set of medications. If the medication is not effective in relieving the symptoms then the medications may be changed.
In case if Epididymo-Orchitis is caused due to a sexually transmitted infection, then the physician will advise the patient to abstain from any sexual activity until the condition is cured. The physician may also advise that the individual's partner also be checked and treated for infection.
In case if Mumps is the cause of Epididymo-Orchitis, then antibiotics will not be effective and supportive treatment is provided and anti-virals given.
For pain relief, supportive care and applying ice to the affected area helps in easing up the pain.
What are the Common Ways to Manage Epididymo-Orchitis?
Some of the ways to manage symptoms of Epididymo-Orchitis are:
- Ice: This goes a long way in helping swelling and pain associated with Epididymo-Orchitis. The individual may put ice in a bag and apply it to the scrotal area for about 15 minutes at a time about three times a day.
- Rest: Adequate rest also goes a long way in relieving pain and discomfort associated with Epididymo-Orchitis. It also facilitates speedy healing and the individual can return to normal activities of daily living quickly.
- Safe Sex: It is always advised to practice safe sex. It is always better to know the sexual history of the partner before involving in any sexual activity. It is imperative to abstain from any sexual activity during the whole course of treatment until the physician gives the okay to do so.
- Scrotal Support: This may be required to elevate the scrotal area for relief from pain and discomfort while sitting or lying down.