Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that carries and stores sperm. Epididymitis is most often caused by sexually transmitted infections (STIs), such as gonorrhea or chlamydia. This condition can affect males of any age.
Symptoms of Epididymitis
Signs and symptoms of epididymitis might include:
- A swollen, inflamed or warm scrotum
- Painful urination
- Testicle pain and tenderness on one side that comes on gradually
- Urgent or frequent urge to urinate
- Discharge from the penis
- Blood in the semen
- Less commonly, fever
- Pain or discomfort in the lower abdomen or pelvic area
When epididymitis lasts longer than six weeks or when it returns is considered chronic. Symptoms of chronic epididymitis might come on gradually.
When to see a doctor
Consult your doctor immediately you notice scrotal pain, swelling, or discharge from your penis when you pass out urine. Pain at this region may require immediate treatment to avoid permanent damage.
Causes of Epididymitis
Causes of epididymitis include:
- The most common causes of epididymitis in sexually active men are gonorrhea and chlamydia.
- Other infections.Bacteria from a urinary tract or prostate infection might spread from the infected site to the epididymis.
- Urine in the epididymis.This occurs when urine flows backward into the epididymis, mostly caused by heavy lifting or straining.
- Trauma or injury in the groin can lead to epididymitis.
- Epididymitis can be caused by tuberculosis infection.
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Engaging in certain sexual behaviors that can lead to STIs can expose you to risk of sexually transmitted epididymitis. These includes:
- Having unprotected sex
- Sex with a partner who has an STI
- A history of STIs
Risk factors for nonsexually transmitted epididymitis include:
- An uncircumcised penis
- History of prostate or urinary tract infections
- History of medical procedures that affect the urinary tract, such as insertion of a urinary catheter or scope into the penis
- Prostate enlargement, which increases the risk of bladder infections and epididymitis
Complications of epididymitis include:
- Puss-filled infection or abscess in the scrotum
- Epididymo-orchitis, if the condition spreads from your epididymis to your testicle
- In rare cases, epididymitis can affect fertility
Practice safer sexual intercourse to help protect against STIs that can cause epididymitis. Consult your doctor if you have recurrent urinary tract infections or other risk factors for epididymitis.
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To diagnose epididymitis, your doctor will check for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. A rectal exam may also be performed by your doctor to check for prostate enlargement or tenderness.
Tests your doctor might recommend include:
- STI screening.This involves inserting a narrow swab into the end of your penis to obtain a sample of discharge from your urethra. The sample is examined in the laboratory for gonorrhea and chlamydia.
- Urine and blood tests.Samples of your urine and blood are analyzed for abnormalities.
- This test might be used to rule out testicular torsion. Ultrasound with color Doppler can determine if the blood flow to your testicles is lower than normal.
To treat bacterial epididymitis and epididymo-orchitis, antibiotics are often prescribed. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. Ensure you take the whole course of antibiotics prescribed by your doctor, even if your symptoms resolve, to ensure that the infection is treated properly.
In some cases, surgery may be required to drain an abscess that has formed. Sometimes, all or part of the epididymis needs to be removed surgically (epididymectomy). Surgery might also be need if epididymitis is caused by underlying physical abnormalities.
Sources: mayoclinic.org, webmd.com
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