What Is Epididymitis?
Epididymitis is an inflammation of one or both of the tubes of the epididymis, a coiled tube which stores sperm inside each testicle. It is caused by a bacterial infection, most often from sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. Epididymitis can also be caused by a urinary tract or prostate infection, or by trauma due to injury or heavy lifting.
Symptoms include redness, swelling, and pain in the testicle; pain on urination or ejaculation; discharge from the penis; and blood in the semen.
Men having unprotected sex are at the highest risk for developing this condition. Treatment involves antibiotics as well as rest, cold packs to the testicles, wearing an athletic supporter, and refraining from lifting and sexual intercourse until the infection is gone.
You should visit your primary care physician within the next 24 hours in order to find out the cause of the infection. If the cause is bacterial, which is common in this condition, antibiotics are prescribed.
How common is Epididymitis?
The diagnosis of epididymitis is made through physical examination, penile swab for STD tests, urine and blood tests, and sometimes ultrasound of the testicles.
Any of these symptoms below should be treated by a medical provider as soon as possible in order to prevent an abscess or permanent damage.
- A scrotum that is swollen, red or warm: Your scrotum may appear bigger than normal, red, warm and tender.
- Pain in the scrotum/testicle: The pain is usually unilateral (one-sided) and develops gradually. Epididymitis does not usually cause sudden-onset pain.
- Painful urination (dysuria): This can also be accompanied by an increased urge to urinate or an increased frequency of urination.
- Penile discharge: Penile discharge is a normal biological function that all men experience. However, penile discharge that differs significantly from your normal pattern in color, consistency or odor can be a sign of epididymitis.
Less common or related symptoms
The symptoms below may not occur in every case of epididymitis, but if they are present, they may be related to this condition.
- Lower abdominal discomfort or pain
- Blood in the semen/ejaculate: This may be difficult to assess, but if you notice any blood coming from the penis, this could be a sign of epididymitis.
- Fever: Even though epididymitis is an infection, it does not commonly present with fever.
It is important to know and recognize the signs and symptoms of epididymitis due to complications that can occur as a result. For example, complications include:
- Abscesses: These are pockets full of pus that can develop in the scrotum due to epididymitis. Abscesses can cause fevers, increased pain and sensitivity and spread of the infection to other portions of the reproductive tract.
- Infectious spread: Epididymitis can spread to the testicle and cause a condition called epididymo-orchitis.
- Fertility problems: This is a rare complication, but epididymitis can result in problems conceiving a child.
Epididymitis is defined as inflammation of the epididymis and it is most often an acute (short-lasting) condition. However, sometimes epididymitis can be chronic and last for multiple weeks. Anything that causes inflammation to the epididymis can cause epididymitis. Causes include:
- Sexually transmitted infections: Many types of bacteria transmitted sexually, especially gonorrhea and chlamydia, can cause epididymitis. Sexually transmitted infections are often the main cause of epididymitis.
- Other infections: Epididymitis is not always sexually transmitted. Many types of outside bacteria can enter the body easily via the genitals, urinary tract and/or prostate and spread to the epididymis. Sometimes, even viral infections can cause epididymitis.
- Trauma: Any direct injury to the genital area can result in epididymitis if there is any cut or opening that can cause infection. Infections due to trauma can also easily spread to the epididymis via the reproductive tract.
- Chemical epididymitis: This condition happens when urine flows backward into the epididymis. This can possibly occur in settings of heavy lifting or straining.
Males of any age can get epididymitis. There are certain behaviors and conditions that can put men more at risk for contracting epididymitis that are important to know.
Risk factors for epididymitis include :
- Having a personal history of sexually transmitted infections
- Having sex without a condom
- Having sex with a partner who has a sexually transmitted infection
- History of prostate or urinary tract infections
- History of medical procedures, such as a urinary catheter or penile scope, that affect the urinary tract/prostate
- Having an uncircumcised penis or anatomical abnormality of the urinary tract
- Enlargement of the prostate (this increases the risk of bladder infections that can lead to epididymitis)
Treatment Options and Prevention for Epididymitis
Epididymitis can be extremely uncomfortable. While you wait for the primary treatment your physician suggests to kick in, you may try some of the following home remedies to help ease your symptoms:
- Rest in bed and lie in a way that elevates the scrotum
- Apply cold packs to your scrotum as needed
- Avoid lifting heavy objects
- Avoid sexual intercourse until the infection has cleared
Treatments from your physician
Depending on the severity and cause of your epididymitis, your physician may use either antibiotics, surgery, or a combination of the two.
- Antibiotics: Antibiotics are available for many sexually transmitted infections and bacteria. It is important that you take the antibiotics consistently and according to your prescribed orders. Your partner will also need treatment if the cause of your epididymitis is due to a sexually transmitted infection .
- Surgery: If an abscess forms as a complication of your epididymitis, you may need surgery to drain it. Sometimes, all or part of the epididymis needs to be removed surgically (epididymectomy). Your physician may also consider surgery if epididymitis is due to underlying physical abnormalities.
Methods for preventing epididymitis include:
- Practice safer sex: Use condoms every time and get tested regularly for sexually transmitted infections .
- Wear proper clothing: Limit use of tight clothing or undergarments as they can generate heat and allow conditions for bacteria and fungi to grow.
- Practice good genital hygiene: Wipe properly (from front to back), take showers and avoid prolonged baths, avoid long intervals between urinating
- Drink water: Increased fluid intake reduces the risk of repeat urinary tract infections that can often lead to epididymitis.
When to Seek Further Consultation for Epididymitis
If you have any of the symptoms of epididymitis, you should be treated by a medical provider as soon as possible in order to prevent abscess or permanent damage.
Questions Your Doctor May Ask to Determine Epididymitis
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Are you sick enough to consider going to the emergency room right now?
- Have you lost your appetite recently?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Any fever today or during the last week?
- How has the intensity of your vomiting changed over time?
The above questions are also covered by our A.I. Health Assistant.
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- What are epididymitis and orchitis? Urology Care Foundation. Urology Care Foundation Link
- Nickel JC. Chronic epididymitis: A practical approach to understanding and managing a difficult urologic enigma. Reviews in Urology. 2003;5(4):209-215. NCBI Link
- Epididymitis and orchitis: What is it? Harvard Medical School: Harvard Health Publishing. Published May 2015. Harvard Health Publishing Link
- Sobol J. Epididymitis. U.S. National Library of Medicine: MedlinePlus. Published October 4, 2016. MedlinePlus Link
- Division of Urology. Epididymitis. Children's Hospital of Philadelphia. Published April 2014. CHOP Link
- Epididymitis. Cleveland Clinic. Published February 7, 2018. Cleveland Clinic Link
- McConaghy JR, Panchal B. Epididymitis: An overview. American Family Physician. 2016;94(9):723-6. NCBI Link