Epididymitis
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Epididymitis

(Epididymo-orchitis)

Pronounced: Ep-i-did-uh-MY-tis

En Español (Spanish Version)

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 for six weeks or more. This type is less common, though.

The Epididymis

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© 2008 Nucleus Medical Art, Inc.

Causes

This condition is most often caused by a bacterial infection. For example:

Other causes include:

Risk Factors

Only men can develop this condition. Risk factors include:

  • Age: 15-30 or over 60
  • 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 defects of the genitourinary tract
  • Unprotected sex
  • Disease that affects the immune system

Symptoms

Symptoms usually develop within a day. These include:

  • Pain in the testes
  • Sudden redness or swelling of the scrotum
  • Hardness, a lump, and/or soreness in the affected testicle
  • Tenderness in the nonaffected testicle
  • Groin pain
  • Chills
  • Fever
  • Inflammation of the urethra
  • Pain during intercourse or ejaculation
  • Pain and/or burning during urination
  • Increased pain while having a bowel movement
  • Lower abdominal discomfort
  • Discharge from the penis
  • Blood in the semen

Diagnosis

Your doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:

  • Urinalysis—to check for a high white blood cell (WBC) count and the presence of bacteria
  • Urine culture—to identify the type of bacteria present
  • Culture of discharge from penis
  • Blood test—to measure the white blood cell count (WBC)
  • Ultrasound—a test that uses sound waves to examine the scrotum

Treatment

Treatment is essential to prevent the infection from worsening. Treatment may include:

  • Bed rest—Stay in bed to keep. This is to keep the testicles from moving and to promote healing. You may need bed rest until the swelling subsides.
  • Antibiotics—You will be given antibiotics to treat a bacterial infection. Take all of your antibiotics, even if you begin to feel better. If you have an STD, your partners will also need treatment.
  • Oral anti-inflammatory medication—This includes drugs, like ibuprofen, to help reduce swelling.
  • Scrotal elevation and support—You may need to wear an athletic supporter for several weeks.
  • Hot baths—Taking baths can ease the pain and help relieve swelling.
  • Surgery—Surgery may be needed in severe cases that keep coming back.

Do not have sex until you and your partner have competed treatment.

Prevention

The following steps can help decrease your risk:

  • Practice safe sex. Protect yourself from STDs by using condoms.
  • Empty your bladder as soon as you feel the need.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/

National Kidney Foundation
http://www.kidney.org/

UrologyHealth.org
http://www.urologyhealth.org/

CANADIAN RESOURCES:

Canadian Health Network
http://www.canadian-health-network.ca/

The Kidney Foundation of Canada
http://www.kidney.ab.ca/

References:

Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guide: 2006. MMWR. 2006;55. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/treatment/2006/rr5511.pdf . Accessed February 5, 2008.

Konety BR. Epididymitis. eMedicine website. Available at: http://www.emedicine.com . Accessed February 2, 2006.

The Merck Manual Diagnosis & Therapy. 17th ed. Rahway, NJ: Merck & Co; 1999.



Last reviewed January 2008 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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