Behind each testicle is present a long coiled tube called Epididymis. The function of epididymis is to move the sperms from testicles and allow their storage and maturation before they are ejaculated. Epididymitis is the inflammation of epididymis. It causes sudden pain in one of the testicles and the scrotum becomes red and swollen. Any problem to epididymis affects sperm movement and can cause male infertility.
Epididymitis affects men of all ages including male children. However, it is more common in age ranging from 14-35 years and is mostly caused by sexually transmitted diseases (STDs) like chlamydia (Chlamydia trichomatis) and gonorrhoea (Neisseria gonorrhoea). It is also caused due to urinary tract or bladder infection by Escherichia.coli/Pseudomonas.
The two main types are acute and chronic epididymitis. Acute epididymitis is sudden in onset, lasts for less than 6 weeks and can be treated. While chronic epididymitis is slow in onset and lasts for more than 6 weeks. Although it is treatable, yet it can recur. In addition, in some cases the cause of chronic epididymitis cannot be determined. Thus, it takes long time to treat chronic epididymitis. When symptoms of acute epididymitis are observed, patient should immediately seek medical help for treatment. One should not ignore it or leave it untreated, since the existing and additional symptoms will increase in severity to cause complications.
What Can Happen If Epididymitis Is Left Untreated?
The symptoms of acute epididymitis which cause discomfort include:
- Fever and chills
- Pain in the abdomen
- Redness and swelling of scrotum
- Abnormal discharge through penis
- Urination becomes painful
- Frequent urge to urinate (with occasional blood in urine)
- Pain experienced in one testicle at one time.
A patient with acute epididymitis should not ignore it, since the symptoms may get worse and develop following complications:
- Pus formation and testicular infarction
- Chronic epididymitis where the inflammation remains for a long time and may not always yield to treatment. It also damages epididymis and testicles and results in male infertility.
- The epididymis may be scarred. This blocks the movement of sperms from testicles into epididymis due to which there is no sperm during ejaculation leading to infertility.
- In rare cases, there is shrinkage of testicles and death of testicular tissue.
- There are chances that the infection may spread from scrotum to other reproductive parts such as testicles, seminal vesicle and prostate.
Treatment of Epididymitis
Acute epididymitis treatment consists of:
- Taking antibiotics depending on the underlying causative agent. Most common medicines are doxycycline and ciprofloxacin. While in case of enteric bacterial infection, both fluoroquinolone and ciprofloxacin are combined.
- Ibuprofen is used to treat pain.
- Piroxicam or ketorolac are prescribed as anti-inflammatory medicines.
- Bed rest is advised.
Additional treatment includes:
- To elevate the scrotum for at least two days to ease the pain. This is done by wearing supportive underwear.
- Cold pack to be applied to the inflamed scrotum.
- Heavy objects should not be lifted.
- These methods help in treating epididymitis within at least 3 months.
- Only when the symptoms are severe then the patient is admitted to the hospital.
Chronic Epididymitis is difficult to treat and options include:
- Anti-inflammatory medicines
- Medicines to soothe nerve pain to scrotum
- Muscle relaxing medicines
- Scrotum is treated with steroid injections or local anesthetics
- Warm baths are advised to promote healing
- If further treatments are required, invasive methods are used in the following cases:
- In case of pus formation, it is removed by surgery or pus is drained with help of the needle.
- When a part or entire epididymis is damaged, it is removed surgically.
- Patient is admitted to hospital in case of severe infection.
Prevention for Epididymitis
When the cause of epididymitis is a sexually transmitted disease, then one should refrain from sexual intercourse with partners. Also, the person with epididymitis should inform about his condition to his partners. One should complete the full course of treatment to prevent the bacteria from developing resistance.
Any type of epididymitis should be treated immediately and should not be ignored. Lack of treatment may cause potential complications in long term which then become difficult to treat.