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:
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Urinary tract infection
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Sexually transmitted diseases, such as chlamydia and gonorrhea
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Infection of the urethra (urethritis)
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Infection of the prostate (prostatitis)
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Tuberculosis
Other causes of epididymitis include:
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Injury
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Viruses, such as the mumps
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Genital abnormalities
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Treatment with the heart rhythm drug amiodarone (Cordarone)
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Chemotherapy to treat bladder cancer
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Only men can develop epididymitis. Other risk factors include:
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Age: 15-30 or over 60
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Infection of the bladder, kidney, prostate, or urinary tract
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Narrowing of the urethra
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Use of a urethral catheter
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Infrequent emptying of the bladder
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Recent surgery or instrumentation of the genitourinary tract (especially prostate removal)
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Birth defects of the genitourinary tract
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Having unprotected sex
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Immunocompromised
Symptoms
Symptoms of epididymitis usually develop within a day. Symptoms may include:
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Pain in the testes
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Sudden redness or swelling of the scrotum
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Hardness, lump, and/or soreness in the affected testicle
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Tenderness in the nonaffected testicle
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Groin pain
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Chills
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Low-grade fever
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Inflammation of the urethra
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Pain during intercourse or ejaculation
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Pain and/or burning during urination
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Increased pain while having a bowel movement
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Lower abdominal discomfort
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Discharge from penis
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Blood in semen
Diagnosis
Your doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:
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Urinalysis – to check for a high white blood cell (WBC) count and the presence of bacteria
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Urine Culture – to identify the type of bacteria present
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Culture of discharge from penis
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Blood Test – to measure the white blood cell count (WBC)
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Ultrasound exam of the scrotum
Treatment
Treatment is essential to avoid spreading the infection to the testicles, which can lead to infertility. Treatment may include the following:
Bedrest – 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.
Hot Baths – Taking hot tub baths can ease the pain and help relieve inflammation.
Surgery – 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:
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org
American Urological Association
http://www.auanet.org
Urological Society of Australia and New Zeland
.http://www.urosoc.org.au
References:
Konety BR. Epididymitis. eMedicine website. Available at: http://www.emedicine.com. Accesse February 2, 2006.
The Merck Manual Diagnosis & Therapy. 17th ed. Merck & Co.; 1999.
