What is Epididymitis?

The epididymis is a series of small tubes that collects and stores sperm. It is attached to the back of each testicle. One of the most common causes of pain in the scrotum is epididymitis. An inflammation of these coiled tubes – which may be due to an infection.

Epididymo-orchitis is the spread of the infection to the testicle.

Epididymitis is usually a secondary bacterial infection that can be triggered by a range of conditions – such as an urinary tract infection (UTI) or a sexually transmissible infection (STI). The bacteria in the urethra (the tube carrying urine and sperm from the penis) move through the urinary and reproductive structures to the epididymis.

Treatment options include antibiotics and bed rest.

Some people develop chronic epididymitis – which is inflammation even when there is no infection.

Symptoms of Epididymitis

When a bacterial infection strikes, the epididymis gradually becomes swollen and painful. This usually happens on one testicle, rather than both. It can last up to 6 weeks if untreated.

You might have one or more of these other possible symptoms:

• Redness, swelling, or tenderness in the scrotum, the sac that contains the testes
• A more frequent or urgent need to pee
• A lump on your testicle
• Painful urination or ejaculation
• Fever
  Blood in the urine
• Burning feeling when urinating
• Pain when ejaculating
• Slight fever
• Chills
• Enlarged testicle
• Sensitivity to touch or pressure in the affected testicle
• Pain in the abdomen or pelvis
• Feeling of heaviness in the affected testicle
• Frequent urge to urinate
• Discharge from the penis

Causes of Epididymitis

Most cases of epididymitis are caused by bacterial infection. Causes include:

• Urinary tract infections (UTIs)
• Sexually transmissible infections (STIs) (such as chlamydia or gonorrhoea)
• Recent genito-urinary surgery – including prostatectomy (surgical removal of all or part of the prostate gland)
• The use of a urinary catheter
• Some congenital kidney and bladder problems.

Diagnosis Of Epididymitis

When you go to the doctor, they will examine your scrotum for signs of infection and ask you questions about your symptoms. They might also do a rectal exam to check your prostate and check for any tenderness.

If your doctor suspects epididymitis based on the exam, you might get one or more tests. They include:

• Urine sample: You may pee into a cup so a lab can check for signs of an infection.
  Blood sample: This can also find abnormalities.
• Swab sample: For this test, your doctor inserts a narrow swab into the tip of your penis to get a sample of discharge. This is used to test for chlamydia or gonorrhea.
• Ultrasound: You might also be asked to sit for an ultrasound test, which uses sound waves to produce an image of your scrotum and testicles.

Complications of Epididymitis

If left untreated, epididymitis can become a “chronic” condition, one that lingers and causes recurring problems.

• Epididymitis might also cause an infection in the scrotum.
• In rare cases, it can damage a man’s ability to make a woman pregnant.

Risk Factors of Epididymitis

Your chances of having epididymitis rise if you have:

• Sex with someone who has a sexually transmitted infection (STI)
• A history of STIs
• A history of infections in your prostate or urinary tract
• A history of procedures that impact your urinary tract
• An uncircumcised penis
• An enlarged prostate

Treatment of Epididymitis

The most common treatment for epididymitis is antibiotics. If your doctor believes you have epididymitis, they might give you a prescription for antibiotics before any lab test results are even back.

You’ll likely take those medications for a week or two, and you’ll usually start feeling better in a matter of days. Always take your full course of antibiotics as prescribed, even when you feel better.

Even after your antibiotics take effect, some swelling may last for weeks or months, and you may still be sore during that time. You can reduce the pain and swelling by taking over-the-counter pain relievers, applying a cold compress, or elevating your scrotum (you might wear supportive underwear, like a jockstrap).

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