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Epididymitis

Definition:
Acute epididymitis is an inflammation of the epididymis. This is a tubular structure that surrounds and attaches to each testicle. The epididymis helps transport and store sperm cells produced in the testicles.

Chronic epididymitis causes pain and inflammation in the epididymis. There is often no swelling of the scrotum. Symptoms last for six weeks or more. This type of epididymitis is less common.

Causes:
Epididymitis is most often caused by a bacterial infection. For example:

  • Urinary tract infection
  • Sexually transmitted diseases, such as chlamydia and gonorrhea
  • Infection of the urethra (urethritis)
  • Infection of the prostate (prostatitis)
  • Tuberculosis

Other causes of epididymitis include:

  • Injury
  • Viruses, such as the mumps
  • Genital abnormalities
  • Treatment with the heart rhythm drug Amiodarone (Cordarone)
Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition. Only men can develop epididymitis. Other risk factors include:
  • Age: 15–30 or over 60
  • Infection of the bladder, kidney, prostate, or urinary tract
  • Narrowing of the urethra
  • Use of a urethral catheter
  • Infrequent emptying of the bladder
  • Recent surgery of the genitourinary tract (especially prostate removal)
  • Birth defects of the genitourinary tract
  • Having unprotected sex
Symptoms:
Symptoms of epididymitis usually develop within a day. Symptoms may include:
  • Pain in the testes
  • Sudden redness or swelling of the scrotum
  • Hardness, lump, and/or soreness in the affected testicle
  • Tenderness in the non-affected testicle
  • Groin pain
  • Chills
  • Low-grade fever
  • Inflammation of the urethra
  • Pain during intercourse or ejaculation
  • Pain and/or burning during urination
  • Increased pain while having a bowel movement
  • Lower abdominal discomfort
  • Discharge from penis
  • Blood in semen
Diagnosis:
Your doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:
  • Urinalysis – to check for a high white blood-cell (WBC) count and the presence of bacteria
  • Urine culture – to identify the type of bacteria present
  • Culture of discharge from penis
  • Blood test – to measure the white blood-cell count (WBC)
  • Ultrasound exam of the scrotum
Treatment:
Treatment is essential to avoid spread of the infection to the testicles, which can lead to infertility. Treatment may include the following:

Bed rest – stay in bed to keep the testicles from moving and promote healing. You will need bed rest until the swelling subsides.

Antibiotics – you will be given antibiotics if your epididymitis is caused by a bacterial infection. Take all of your antibiotics, even if you begin to feel better. If it is possible that your epididymitis is sexually transmitted, your partner may also need treatment with antibiotics.

Oral Anti-Inflammatory Medication – this includes drugs such as ibuprofen to help reduce swelling.

Scrotal Elevation and Support – After symptoms have improved, you'll need to wear an athletic supporter for several weeks.

Ice Packs – ice packs placed on the affected area can help reduce swelling.

Surgery – may be required in very severe or recurrent cases of epididymitis.

Avoid sexual intercourse or ejaculation for at least one month during recovery and after symptoms disappear.

Prevention:
The following steps can help decrease your risk of epididymitis:
  • Practice safe sex and protect yourself from sexually transmitted diseases by using condoms.
  • Empty your bladder as needed; do not “hold” urine for long periods of time.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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