Epididymitis: Signs, Diagnosis, and Treatment
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Epididymitis

What Is Epididymitis?

Epididymitis is an inflammation of the epididymis. The epididymis is a tube located at the back of the testicles that stores and carries sperm. When this tube becomes swollen, it can cause pain and swelling in the testicles.

Epididymitis can affect men of all ages, but it’s most common in men between ages 19 and 35. It’s usually caused by a bacterial infection or a sexually transmitted infection (STI). The condition usually improves with antibiotics. 

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What Are the Symptoms of Epididymitis?

Symptoms

Epididymitis may begin with only a few mild symptoms. When it’s left untreated, however, the symptoms tend to get worse. 

People with epididymitis may experience:

  • a low-grade fever
  • chills
  • pain in the pelvic area
  • pressure in the testicles
  • pain and tenderness in the testicles
  • redness and warmth in the scrotum
  • enlarged lymph nodes in the groin
  • pain during sexual intercourse and ejaculation
  • pain during urination or bowel movements
  • urgent and frequent urination
  • abnormal discharge
  • blood in the semen

Who Is at Risk for Epididymitis?

Risk Factors

The most common cause of epididymitis is an STI, specifically gonorrhea and chlamydia. However, epididymitis can also be caused by a non-sexually transmitted infection, such as a urinary tract infection or prostate infection. 

You may be more at risk for epididymitis if you: 

  • are uncircumcised
  • have unprotected sex
  • have structural problems within the urinary tract
  • have tuberculosis
  • have an enlarged prostate causing blockage in the bladder
  • recently had urinary tract surgery
  • recently experienced a groin injury
  • use a urinary catheter
  • use a heart medication called amiodarone 

How Is Epididymitis Diagnosed?

Diagnosis

Your doctor will first complete a physical examination. They’ll look for swelling of the testicles, swelling of the lymph nodes in the groin area, and abnormal discharge from the penis. If there’s discharge, your doctor will use a cotton swab to collect a sample and test for STIs.

Your doctor may also perform the following tests and procedures:

  • Your doctor will conduct a rectal examination if they suspect that an enlarged prostate caused your condition.
  • Your doctor may also order certain blood tests, such as a complete blood count, to determine whether there’s an infection in your system.
  • Your doctor may ask for a urine sample as well. Results of a urinalysis can indicate if you  have a urinary tract infection or an STI.
  • Imaging tests may be done to rule out other conditions. These tests produce detailed images of the body, allowing your doctor to see structures in the body very clearly. Your doctor might order a testicular ultrasound to obtain images of the testicles and the surrounding tissues in the scrotum.

How Is Epididymitis Treated?

Treatment

Treatment for epididymitis involves treating the underlying infection and easing symptoms. 

Common treatments include: 

  • antibiotics
  • pain medication
  • anti-inflammatory medication
  • bed rest
  • elevating the scrotum
  • applying cold packs to the scrotum
  • wearing an athletic cup for support
  • avoiding lifting heavy objects
  • abstaining from sexual intercourse

These methods are usually successful. However, more invasive treatment may be needed in some cases. 

If an abscess has formed on the testicles, your doctor can drain the pus using a needle.

Surgery is another option if no other treatments have been successful. This involves removing all or part of the epididymis. Surgical treatment may also be necessary to correct any physical defects that may be causing epididymitis. 

What Is the Outlook for Someone with Epididymitis?

Outlook

Most cases of epididymitis are successfully treated using antibiotics. There are usually no long-term sexual or productive problems. However, the infection can return in the future. It’s also possible for complications to occur, but this is rare.

Potential complications include: 

  • long-term epididymitis
  • shrinkage of the testicles
  • a fistula, or an abnormal passageway, in the scrotum
  • the death of testicular tissue
  • infertility 

It’s important to seek treatment right away to prevent complications. Once treatment is received, it’s important that you take your entire course of antibiotics to treat the infection. You should also see your doctor after you’ve finished the medication to make sure that the infection has cleared. This will help ensure that you make a complete recovery.

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