Epididymitis


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Epididymitis is an inflammation of the epididymis. It is located at the back of the testicles and the location where sperm is stored. Infections and sexually transmitted diseases (STDs) are among the main causes of Epididymitis. E. Coli, Chlamydia, and Gonorrhea can lead to Epididymitis.

This condition is often painful, with the scrotum enduring redness, swelling, inflammation, soreness and sharp pain. Men who experience sudden scrotal pain should be tested to find out if Epididymitis is present. It is the most frequent cause of this pain.

There are two types of Epididymitis: acute and chronic. Acute Epididymitis is any swelling and pain that happens for less than 6 weeks. Chronic Epididymitis is characterized by swelling and pain progressing for more than 3 months. Furthermore, chronic Epididymitis can be classified in three other categories: inflammatory chronic Epididymitis, obstructive chronic Epididymitis, and chronic Epididymalgia.

Men who are under the age of 35 often contract Epididymitis through sexual contact. Men over the age of 35 rarely contract it from sexual intercourse, but rather from a urinary-tract infection, urinary-tract surgery, systemic disease, or immunosuppression. It can be caused by the spread of infection from the urethra or bladder.

A medication called Amiodarone, which is used to treat individuals with abnormal heart rhythms, has been attributed to causing Epididymitis.

If the pain becomes unbearable, hospitalization is necessary; otherwise most men can be treated on an out-patient basis.

Symptoms of Epididymitis

In the beginning, Epididymitis causes light fever and chills. A heaviness sensation can also be experienced in the testicles, and as a result, they become increasingly more sensitive to pressure.

Other symptoms to look for include:

  • Pain during ejaculation
  • Groin pain
  • Fever
  • Lump(s) in the testicles
  • Blood in the semen
  • Discharge from penis opening (urethra)
  • Pelvic or lower abdomen pain
  • Pain during urination
  • Burning sensation during urination
  • Tenderness in groin area
  • Pain during bowel movement

Diagnosing Epididymitis

A diagnosis for Epididymitis can be done in several ways. First, observation and a physical examination can reveal a sore, tender and red area on the scrotum (likely the affected part). A rectal examination can further show an enlarged prostate, which is a sign of Epididymitis.

A complete blood count (CBC) can be conducted; a Doppler ultrasound is used frequently and can determine if there is an increased blood flow. In addition, a urinalysis can be done to diagnose Epididymitis.

Since Epididymitis can be caused by Chlamydia and Gonorrhea, procedures to test for these STDs are common.

Treatment for Epididymitis

Epididymitis can be treated with antibiotics. The treatment course lasts for 3 weeks and is meant to be done in combination with a good amount of bed rest for the pain. Elevating the scrotum can help alleviate a lot of the pain. Patients are advised to avoid hot compresses to reduce pain as the heat can destroy the inner sperm tubes. Anything cold, like bags of ice, may be used.

Antibiotics used to treat acute Epididymitis are Ceftriaxone 250mg and Doxycycline100mg twice a day for 10 days, or Ofloxacin 300mg twice a day for 10 days, and Levofloxacin 500mg once a day for 10 days.

It is mandatory for patients to follow up within 3 days of treatment; otherwise an entire reevaluation is necessary. New tests will have to be done and a new treatment course will have to be prescribed.

What Happens if Epididymitis Goes Untreated?

If Epididymitis goes untreated it can cause permanent damage to the reproductive system in men. As a result, infertility is the main consequence of going without treatment.

Epididymitis, left untreated, can progress from acute to chronic. Also, an abscess can occur. This is a pus accumulation in the epididymis, and the pus can be drained only by surgery.

Lastly, the infection can also spread from the epididymis to damage other areas of the body.

Preventing Epididymitis:

Early diagnosis is the best way to prevent Epididymitis from becoming a problem. Since the inflammation is caused by certain STDs, avoiding sexual intercourse altogether can prevent you from contracting the condition. If intercourse cannot be avoided, practicing safe sex and using condoms during each sexual encounter can greatly reduce your risk of being infected with an STD; therefore, reducing your chances of getting Epididymitis.

Once Epididymitis has occurred, there is no way to prevent it, just the ability to treat it. Safe sex is the best way to prevent acquiring this condition.

Who is at Risk for Contracting Epididymitis?

The following includes those people that are at a higher risk of contracting Epididymitis:

  • Men with new sexual partners
  • Men with more than 2 partners
  • Men not using any method of protection
  • Abusing drugs and alcohol before sexual intercourse
  • Men that have already had an STD
  • Homosexual Men
  • Men with a history of prostate infections
  • Men with a history of urinary tract infections
  • Men who are uncircumcised
  • Undergoing medical procedures that affect the urinary tract
  • Having an enlarged prostate
  • Men who regularly use a catheter

Statistics about Epididymitis

The following are some important statistics about Epididymitis:

  • 600,000 new cases are reported each year in America
  • Epididymitis occurs most frequently in men between the ages of 19 and 35
  • In the United States, 20 percent of men admitted to the hospital for urological illnesses are diagnosed with Epididymitis
2.6 percent of men who have had a vasectomy experience Epididymitis.

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