What is Epididymitis
Epididymitis is swelling (inflammation) of the epididymis. The epididymis is a cord-like structure that is located along the top and back part of the testicle. It collects and stores sperm from the testicle.
This condition can also cause pain and swelling of the testicle and scrotum. Symptoms usually start suddenly (acute epididymitis). Sometimes epididymitis starts gradually and lasts for a while (chronic epididymitis). This type may be harder to treat.
What are the causes?
In men 35 and younger, this condition is usually caused by a bacterial infection or sexually transmitted disease (STD), such as:
- Gonorrhea.
- Chlamydia.
In men 35 and older who do not have anal sex, this condition is usually caused by bacteria from a blockage or abnormalities in the urinary system. These can result from:
- Having a tube placed into the bladder (urinary catheter).
- Having an enlarged or inflamed prostate gland.
- Having recent urinary tract surgery.
In men who have a condition that weakens the body’s defense system (immune system), such as HIV, this condition can be caused by:
- Other bacteria, including tuberculosis and syphilis.
- Viruses.
- Fungi.
Sometimes this condition occurs without infection. That may happen if urine flows backward into the epididymis after heavy lifting or straining.
What increases the risk?
This condition is more likely to develop in men:
- Who have unprotected sex with more than one partner.
- Who have anal sex.
- Who have recently had surgery.
- Who have a urinary catheter.
- Who have urinary problems.
- Who have a suppressed immune system.
What are the signs or symptoms?
This condition usually begins suddenly with chills, fever, and pain behind the scrotum and in the testicle. Other symptoms include:
- Swelling of the scrotum, testicle, or both.
- Pain when ejaculating or urinating.
- Pain in the back or belly.
- Nausea.
- Itching and discharge from the penis.
- Frequent need to pass urine.
- Redness and tenderness of the scrotum.
How is this diagnosed?
Your health care provider can diagnose this condition based on your symptoms and medical history. Your health care provider will also do a physical exam to ask about your symptoms and check your scrotum and testicle for swelling, pain, and redness. You may also have other tests, including:
- Examination of discharge from the penis.
- Urine tests for infections, such as STDs.
Your health care provider may test you for other STDs, including HIV.
How is this treated?
Treatment for this condition depends on the cause. If your condition is caused by a bacterial infection, oral antibiotic medicine may be prescribed. If the bacterial infection has spread to your blood, you may need to receive IV antibiotics. Nonbacterial epididymitis is treated with home care that includes bed rest and elevation of the scrotum.
Surgery may be needed to treat:
- Bacterial epididymitis that causes pus to build up in the scrotum (abscess).
- Chronic epididymitis that has not responded to other treatments.
Follow these instructions at home:
Medicines
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if your condition improves.
Sexual Activity
- If your epididymitis was caused by an STD, avoid sexual activity until your treatment is complete.
- Inform your sexual partner or partners if you test positive for an STD. They may need to be treated. Do not engage in sexual activity with your partner or partners until their treatment is completed.
General instructions
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Keep your scrotum elevated and supported while resting. Ask your health care provider if you should wear a scrotal support, such as a jockstrap. Wear it as told by your health care provider.
- If
directed, apply ice to the affected area:
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times per day.
- Try taking a sitz bath to help with discomfort. This is a warm water bath that is taken while you are sitting down. The water should only come up to your hips and should cover your buttocks. Do this 3–4 times per day or as told by your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have a fever.
- Your pain medicine is not helping.
- Your pain is getting worse.
- Your symptoms do not improve within three days.
