Epididymitis

What is epididymitis?

Epididymitis is an inflammation of the epididymis. The epididymis is the tube through which sperm pass. The tube is located at the back of each testicle. Epididymitis can affect both testicles, but it most often occurs on just one side.

How does it occur?

Epididymitis is caused by bacterial infections, such as:

• urinary tract infections
• sexually transmitted diseases such as chlamydia or gonorrhea
• prostatitis (infection of the prostate).

It may also happen if you have:

• a fungal infection
• Henoch-Schoenlein purpura (a disease that causes a rash and swelling of joints)
• a prostatectomy (removal of the prostate)
• a medical procedure that affects your urinary tract, such as cystoscopy (looking at the inside of the bladder through a slim, flexible, lighted tube) or a catheter (a small tube put into the bladder to drain the urine from your body).

Sometimes men have epididymitis when they are taking a heart medicine called amiodarone (Cordarone).

What are the symptoms?

Possible symptoms of epididymitis are:

• red, warm skin on the scrotum
• tender, swollen testicle or groin area on one side
• testicle pain that feels worse when you have a bowel movement
• fever and chills
• discharge from the urethra (the opening at the end of the penis)
• pain or burning when you urinate
• pain with intercourse or ejaculation
• testicular lump
• lower abdominal discomfort or pelvic discomfort
• blood in the semen.

Because pain in the testicles can be a symptom of another, more serious problem (testicular torsion), contact your healthcare provider right away if you have this symptom.

How is it diagnosed?

Your healthcare provider will examine your groin and scrotum to rule out other possible diagnoses. You may have a rectal exam. You may also have these tests:

• urine tests
• tests for chlamydia and gonorrhea
• blood tests.

How is it treated?

Your healthcare provider may prescribe one or more antibiotics. Your sexual partner may need to be treated at the same time to prevent reinfection. Your provider may prescribe another medicine to control pain and inflammation.

Sometimes severe cases of epididymitis need surgery.

If you have an infection, it is very important to have a follow-up visit with your healthcare provider to make sure the infection is completely cleared up.

How long do the effects last?

The pain usually gets better within 1 to 3 days. The symptoms may return if antibiotics do not kill all of the bacteria. Symptoms may also return if bacteria from the urinary tract or from sexual contact reinfect the epididymis. If this happens, you will need more treatment with antibiotics.

Chronic epididymitis is more of a problem. Chronic means that the infection continues even after treatment. Taking anti-inflammatory medicine for a longer time may be helpful. If antibiotics and pain medicine do not help, surgery to remove the epididymis (epididymectomy) may be necessary. If the infection spreads to the testis, you may become infertile (unable to have children).

How can I take care of myself?

• Take all of the medicine prescribed by your healthcare provider.
• Follow your healthcare provider's directions.
• If you are very uncomfortable, you may need to rest in bed for a couple of days.
• Use an ice pack to help relieve the pain. (Do not leave the ice pack on your skin for longer than 20 minutes and do not use it more often than once every hour.)
• Raise the scrotum by putting a rolled-up towel under it when you are resting.
• You can help relieve pain and discomfort by wearing an athletic supporter or jockey shorts instead of boxers.
• If you have an infection, do not have sexual intercourse until the infection clears up.

What can I do to help prevent epididymitis?

• Keep the penis and scrotum clean.
• If you have symptoms of burning when you urinate or a discharge from the penis, see your healthcare provider promptly.
• Use a latex or polyurethane condom every time you have sexual intercourse to protect against sexually transmitted diseases.