Summary about Disease
Infectious epididymitis is an inflammation of the epididymis, a coiled tube located at the back of the testicle that stores and carries sperm. The inflammation is typically caused by a bacterial infection. It can cause pain, swelling, and redness in the scrotum.
Symptoms
Scrotal pain and tenderness
Swelling in the scrotum
Redness of the scrotum
Painful urination
Frequent urination
Urgency to urinate
Discharge from the urethra
Pain during intercourse or ejaculation
Fever (in some cases)
Chills (in some cases)
Causes
Sexually Transmitted Infections (STIs): Primarily Chlamydia trachomatis and Neisseria gonorrhoeae are the most common causes, especially in younger, sexually active men.
Bacterial Infections: In older men, E. coli and other bacteria associated with urinary tract infections or prostate infections are frequent causes.
Less Common Causes: Viral infections, certain medications (amiodarone), trauma, or autoimmune diseases can rarely cause epididymitis.
Medicine Used
Antibiotics: The primary treatment. The specific antibiotic prescribed depends on the suspected cause:
For suspected STIs (Chlamydia or Gonorrhea): Ceftriaxone (intramuscular injection) followed by doxycycline (oral). Azithromycin can be used as an alternative.
For suspected non-STI bacterial infections (E. coli, etc.): Levofloxacin, ciprofloxacin, or ofloxacin.
Pain Relievers: Over-the-counter pain relievers like ibuprofen or naproxen can help manage pain and inflammation. Stronger pain medications may be prescribed for severe pain.
Is Communicable
Yes, if the infectious epididymitis is caused by a sexually transmitted infection (STI) such as Chlamydia or Gonorrhea. In this case, it is communicable through sexual contact. Non-STI-related epididymitis is generally not considered communicable.
Precautions
Abstinence from sexual activity: If the epididymitis is caused by an STI, avoid sexual contact until you and your partner(s) have completed treatment.
Safe Sex Practices: Use condoms consistently and correctly to prevent the spread of STIs.
Proper Hygiene: Practice good hygiene, including washing your hands frequently, especially after using the restroom.
Follow Doctor's Instructions: Adhere strictly to your doctor's prescribed medication regimen and follow-up appointments.
Elevate the scrotum: Use an athletic supporter or rolled towel to elevate the scrotum, which can help reduce pain and swelling.
Cold Packs: Apply cold packs to the scrotum for 15-20 minutes at a time, several times a day, to reduce swelling and pain.
How long does an outbreak last?
With appropriate antibiotic treatment, symptoms usually begin to improve within 2-3 days. The full course of antibiotics should be completed (usually 10-21 days, depending on the antibiotic and severity of infection) to eradicate the infection. Pain and swelling may persist for several weeks, even after the infection is cleared. Chronic epididymitis, lasting longer than 3 months, can occur in some cases.
How is it diagnosed?
Physical Examination: The doctor will examine the scrotum, testicles, and groin area.
Medical History: The doctor will ask about your symptoms, sexual history, and medical history.
Urine Tests: A urine sample will be tested for bacteria and other signs of infection.
STI Testing: Swabs from the urethra will be taken to test for Chlamydia and Gonorrhea.
Ultrasound: An ultrasound of the scrotum may be performed to rule out other conditions, such as testicular torsion or tumor, and to assess blood flow to the testicles.
Digital Rectal Exam: In older men, a digital rectal exam may be performed to check for prostate enlargement or infection.
Timeline of Symptoms
Early Stage: Gradual onset of pain and tenderness in the scrotum, often on one side. Mild swelling may be present.
Progressive Stage: Pain intensifies, and swelling increases. Redness of the scrotum may develop. Urinary symptoms (painful, frequent, or urgent urination) and urethral discharge may appear, especially with STIs.
Late Stage (If Untreated): Severe pain, significant swelling, and possible fever/chills. Abscess formation or spread of infection to other areas is possible if left untreated. The condition can become chronic, with persistent pain and discomfort.
Important Considerations
Differential Diagnosis: It's important to rule out other conditions that can cause similar symptoms, such as testicular torsion (medical emergency), testicular cancer, hydrocele, or varicocele.
Partner Notification: If the epididymitis is caused by an STI, it's crucial to notify your sexual partner(s) so they can be tested and treated to prevent further spread of the infection and reinfection.
Adherence to Treatment: Complete the entire course of antibiotics, even if you start feeling better, to ensure the infection is completely eradicated and to prevent antibiotic resistance.
Follow-up: Attend all follow-up appointments with your doctor to ensure the infection is cleared and to monitor for any complications.
Chronic Epididymitis: If symptoms persist for more than 3 months, it is considered chronic epididymitis, which can be more difficult to treat and may require different management strategies.