Epididymitis

What is epididymitis?

Epididymitis is an inflammation (irritation and swelling) of the epididymis. The epididymis is the firm tube at the back of each testicle. This coiled tube stores and carries sperm. One or both testicles may be affected, but it most often happens on just 1 side. The inflammation causes pain and swelling.

How does it occur?

Bacterial infections can cause epididymitis, such as:

• urinary tract infections
• sexually transmitted diseases such as chlamydia or gonorrhea
• infection of the prostate gland.

It may also happen if you have:

• a fungal infection
• Henoch-Schönlein purpura, which is a disease that causes a rash and swelling of joints
• removal of the prostate
• a medical procedure that affects your urinary tract, such as cystoscopy or a catheter.

Sometimes men have epididymitis when they are taking a heart medicine called amiodarone.

What are the symptoms?

Possible symptoms are:

• red, warm skin on the scrotum
• tender, swollen testicle or groin area
• testicle pain that feels worse when you have a bowel movement
• fever and chills
• nausea
• discharge from the urethra (the opening at the end of the penis)
• pain or burning when you urinate
• pain with sex
• lump in a testicle
• discomfort in your lower abdomen, flank, or pelvis
• blood in the semen.

If you have pain in the testicles and you don’t know what is causing it, contact your healthcare provider right away. It could be a symptom of a more serious problem.

How is it diagnosed?

Your healthcare provider will examine your groin and scrotum. You may have a rectal exam. You may also have these tests:

• urine tests
• tests for chlamydia and gonorrhea
• blood tests.

How is it treated?

Your healthcare provider may prescribe antibiotic medicine. Your sexual partner may need to be treated at the same time to prevent reinfection. Your provider may prescribe another medicine for pain and inflammation. Sometimes severe cases need surgery.

If you have an infection, it is very important to have a follow-up visit with your healthcare provider to make sure the infection is completely cleared up.

How long do the effects last?

The pain usually gets better in 1 to 3 days. If it is caused by a bacterial infection, the symptoms may come back if antibiotics do not kill all of the bacteria. Symptoms may also come back if bacteria from the urinary tract or from sexual contact reinfect the epididymis. If this happens, you will need more treatment with antibiotics. It is important to treat the infection completely to try to prevent chronic epididymitis and to keep the infection from spreading to the testicle. Spread of the infection to the testicles could make you infertile (unable to have children).

Chronic epididymitis is more of a problem. Why some men get chronic epididymitis is not known. Chronic means that the infection continues even after treatment or that the infection or symptoms similar to infection return frequently. The discomfort or pain of chronic epididymitis can be treated with antibiotics or anti-inflammatory medicine. If antibiotics and pain medicine do not help, surgery to remove the epididymis may be necessary.

How can I take care of myself?

• Take all of the medicine prescribed by your healthcare provider.
• Follow your provider's directions.
• If you are very uncomfortable, you may need to rest in bed for a couple of days.
• Raise the scrotum by putting a rolled-up towel under it when you are resting.
• Use a cloth-covered ice pack to help relieve the pain. Do not leave the ice pack on your skin for longer than 20 minutes and do not use it more often than once every hour.
• Wear an athletic supporter or jockey shorts instead of boxers to help relieve discomfort.
• If you have an infection, don’t have sex until the infection clears up.

What can I do to help prevent epididymitis?

• Keep the penis and scrotum clean.
• If you have symptoms of burning when you urinate or a discharge from the penis, see your healthcare provider promptly.
• Use a latex or polyurethane condom every time you have sex to protect against sexually transmitted diseases.