Epididymitis
Epididymitis is an inflammation of the epididymis, a tube-like structure that surrounds each testicle and plays a crucial role in transporting and storing sperm. This condition can manifest acutely or chronically, with symptoms including testicular pain, swelling of the scrotum, and discomfort during urination. Common causes of epididymitis include bacterial infections, particularly those related to the urinary tract and sexually transmitted infections like chlamydia and gonorrhea. Risk factors include recent surgeries, urinary tract infections, and unprotected sexual activity, with males aged 15 to 30 and those over 60 being at higher risk.
Diagnosis typically involves a thorough medical history, physical examination, and various tests like urinalysis and ultrasound. Treatment is vital to prevent complications and often includes antibiotics, pain relief medications, and rest. Preventive measures focus on safer sexual practices and proper bladder care. Understanding epididymitis is important for maintaining reproductive health and addressing potential complications effectively.
Epididymitis
- ANATOMY OR SYSTEM AFFECTED: Genitalia, reproductive system, skin
- ALSO KNOWN AS: Epididymo-orchitis
Definition
Acute epididymitis is an inflammation of the epididymis. This is a structure shaped like a tube that surrounds and attaches to each testicle. The epididymis helps transport and store sperm cells.
Chronic epididymitis causes pain and inflammation in the epididymis. There is often no swelling of the scrotum. Symptoms can last six weeks or more, but this type is less common.
Causes
Epididymitis is most often caused by bacterial infections such as those of the urinary tract, by sexually transmitted infections (STIs) such as chlamydia and gonorrhea, by infection of the urethra (urethritis), by infection of the prostate (prostatitis), and by tuberculosis. Other causes include injury, viral infections such as mumps, genital abnormalities, treatment with the heart rhythm drug amiodarone (Cordarone), and chemotherapy to treat bladder cancer.
Risk Factors
Risk factors for epididymitis include infection of the genitourinary tract (bladder, kidney, prostate, or testicle), narrowing of the urethra, use of a urethral catheter, infrequent emptying of the bladder, recent surgery or instrumentation of the genitourinary tract (especially prostate removal), birth disorders of the genitourinary tract, unprotected sex, and disease that affects the immune system. Most at risk are males ages fifteen to thirty years and men older than age sixty.
Symptoms
Symptoms usually develop within a day and include pain in the testes; sudden redness or swelling of the scrotum; hardness, a lump, or soreness (or all three) in the affected testicle; tenderness in the unaffected testicle; groin pain; chills; fever; inflammation of the urethra; pain during intercourse or ejaculation; pain or burning, or both, during urination; increased frequency of urination; increased pain while having a bowel movement; lower abdominal discomfort; discharge from the penis; and blood in the semen.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and perform a physical exam. Tests may include a urinalysis to check for a high white blood cell (WBC) count and the presence of bacteria; a urine culture to identify the type of bacteria present; a culture of discharge from the penis; a blood test to measure the white blood cell count (WBC); and an ultrasound (a test that uses sound waves to examine the scrotum). Nucleic Acid Amplification Tests (NAATs) and gram stains of urethral secretions may also be used.
Treatment and Therapy
Treatment is essential to prevent the infection from worsening. Treatment may include bed rest. The patient should stay in bed to keep the testicles from moving and to promote healing. Bed rest might be necessary until the swelling subsides. Another treatment is antibiotics, prescribed for bacterial infections. If the patient has an STI, his partners will also need treatment. Another treatment is oral anti-inflammatory medication, which includes drugs such as ibuprofen to help reduce swelling.
The patient may need to wear an athletic supporter for several weeks. Taking baths can ease the pain and help relieve swelling. One should not have sex until treatment is completed. Finally, surgery may be needed in severe cases that return.
Prevention and Outcomes
To help decrease the risk of developing epididymitis, one should practice safer sex. One can protect against STIs by using condoms. Finally, one should empty one’s bladder when feeling the need to do so.
Bibliography
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"Epididymitis - Symptoms and Causes." Mayo Clinic, 6 Apr. 2023, www.mayoclinic.org/diseases-conditions/epididymitis/symptoms-causes/syc-20363853. Accessed 10 Nov. 2024.
Lunenfeld, Bruno, and Louis Gooren, editors. Textbook of Men’s Health. Parthenon, 2007.
Rupp, Timothy J., and Stephen W. Leslie. "Epididymitis - StatPearls." NCBI, 17 July 2023, www.ncbi.nlm.nih.gov/books/NBK430814. Accessed 10 Nov. 2024.
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