Summary about Disease
Epididymitis is an inflammation of the epididymis, a coiled tube located at the back of the testicle that stores and carries sperm. It most commonly occurs in men between the ages of 14 and 35. It is often caused by a bacterial infection, including sexually transmitted infections (STIs), but can also be caused by non-infectious conditions.
Symptoms
Gradual pain in the scrotum
Redness and warmth in the scrotum
Testicle pain and tenderness, usually on one side
Painful urination
Frequent urination
Urgent need to urinate
Discharge from the urethra
Pain or discomfort in the lower abdomen or pelvis
Blood in semen
Swollen scrotum
Lump in the testicle
Enlarged lymph nodes in the groin
Fever
Causes
Bacterial infections: Often sexually transmitted infections (STIs) like chlamydia and gonorrhea are the most common cause in young, sexually active men. Non-sexually transmitted bacterial infections can also cause epididymitis, especially in older men, often associated with urinary tract infections (UTIs) or prostate infections.
Non-infectious causes:
Urine backflow into the epididymis (chemical epididymitis)
Trauma or injury to the groin
Certain medications (e.g., amiodarone)
Autoimmune diseases (rare)
Medicine Used
Antibiotics: The primary treatment, especially for bacterial infections. Common antibiotics include:
Ceftriaxone and Doxycycline (for STIs)
Levofloxacin or Ciprofloxacin (for non-STI bacterial infections)
Pain relievers:
Ibuprofen or Naproxen (NSAIDs)
Acetaminophen
Scrotal support: An athletic supporter can help alleviate discomfort.
Is Communicable
Epididymitis caused by sexually transmitted infections (STIs) is communicable through sexual contact. Epididymitis caused by non-infectious causes or non-sexually transmitted bacteria is not communicable.
Precautions
Practice safe sex: Use condoms to prevent STIs.
Urinate after intercourse: This can help flush out bacteria.
Treat UTIs promptly: Address urinary tract infections quickly.
Avoid activities that cause groin trauma: Be careful during sports or other physical activities.
Follow doctor's instructions: Take medications as prescribed and attend follow-up appointments.
Rest and elevate the scrotum: This can help reduce swelling and pain.
How long does an outbreak last?
With appropriate antibiotic treatment, symptoms usually start to improve within a few days. The full course of antibiotics needs to be completed, even if symptoms subside. It may take several weeks for the pain and swelling to completely resolve. Chronic epididymitis, which lasts longer than 6 weeks, may require further evaluation and management.
How is it diagnosed?
Physical examination: The doctor will examine the scrotum, testicles, and groin.
Medical history: Questions about symptoms, sexual activity, and medical conditions.
Urine test: To check for urinary tract infection and STIs.
STI testing: Swabs taken from the urethra to test for chlamydia and gonorrhea.
Scrotal ultrasound: Imaging to rule out other conditions, such as testicular torsion or a tumor. In some cases, it can show inflammation or abscess.
Other tests: May be ordered based on suspected underlying causes.
Timeline of Symptoms
The progression can vary, but a typical timeline might look like this:
Days 1-3: Gradual onset of pain and discomfort in the scrotum.
Days 3-7: Increasing pain, redness, and swelling. Urinary symptoms may appear.
Days 7-14: Symptoms may peak. If untreated, fever and discharge may develop.
With treatment (antibiotics): Improvement usually begins within a few days, with gradual resolution of symptoms over several weeks.
Chronic Epididymitis: Symptoms persist for more than 6 weeks, potentially with recurring episodes of pain and swelling.
Important Considerations
Differential diagnosis: It is important to rule out other conditions that can cause similar symptoms, such as testicular torsion, which is a medical emergency.
Partner notification: If the epididymitis is caused by an STI, sexual partners should be notified and tested/treated.
Follow-up: It's important to follow up with the doctor to ensure the infection has cleared and to address any persistent symptoms or underlying conditions.
Chronic pain management: If chronic epididymitis develops, pain management strategies may be needed.
Infertility: While rare, untreated epididymitis can sometimes lead to infertility.