Epididymitis

Causes and Risks:
Epididymitis is typically caused by bacterial organisms associated with urinary tract infections , sexually-transmitted diseases (such as chlamydia and gonorrhea ), prostatitis (infection of the prostate) or prostatectomy (removal of the prostate). An increased risk is associated with sexually active men who are not monogamous and do not use condoms . Men who have recently had surgery or have a history of structural problems involving the genito-urinary tract are also at increased risk (regardless of their sexual behaviors).

Epididymitis may begin with a low grade fever and chills and a heavy sensation in the testicle. The testicle becomes increasingly sensitive to pressure or traction. There may be lower abdominal discomfort or pelvic discomfort and urination may cause burning or pain. On occasion there may be a discharge from the urethra, blood in the semen or pain on ejaculation.

Prevention:
Epididymitis may be prevented by early diagnosis and adequate treatment (plus reporting if applicable) of the infectious diseases associated with it. Prophylactic (preventive course) antibiotics are frequently given at the time of surgeries. Safer sexual practices (monogamous relationships, use of barriers such as condoms , and similar practices) may be helpful in preventing those cases of epididymitis associated with sexually-transmitted diseases. Condoms should be used with any sex partner whose health status is unknown.

Symptoms:



Signs and Tests:
Physical examination shows a tender and sometimes swollen testicle on the affected side. Tenderness can usually be localized to a small area of the testicle where the epididymitis is attached. Enlarged lymph nodes in the groin area (inguinal nodes) may be present. There may be a discharge from penis . A rectal examination may reveal an enlarged or tender prostate.

These tests may be performed:



Treatment:
Antibiotics are prescribed. Chlamydial infections are usully treated using tetracycline. Sexual partners may also be treated. Bedrest, with elevation of the scrotum and ice packs applied to the area, is recommended. It is very important to have a follow-up visit with your health care provider to evaluate if the infection has completely resolved.

Prognosis:
Epididymitis usually resolves with appropriate antibiotic therapy, without any damage to prior sexual or reproductive abilities. Recurrence is fairly common.

Complications:
Infrequently, chronic epididymitis may develop. Surgery may be necessary. If the infection spreads to the testis , infertility may result.

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms of epididymitis develop.


This is an internal view of the male reproductive system.