Epididymitis

Epididymitis is inflammation or infection of the epididymis, which is the long tube that rests along the testicles and stores and carries sperm. Epididymitis can occur at any age and may be caused by any one of several issues, including sexually transmitted diseases (STDs), other bacterial infections, and injury.

Symptoms

Common signs and symptoms of epididymitis include:

• A swollen, red, or warm scrotum
• Testicle pain and tenderness (usually comes on gradually on one side)
• Painful urination or urgent need to urinate frequently
• Discharge from the penis
• Pain or discomfort in the lower abdomen or pelvic area
• Blood in the semen

Chronic epididymitis lasts longer than six weeks or recurs.

Causes and Risk Factors

Epididymitis is most often caused by a bacterial infection, such as a sexually transmitted disease. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.

Other causes include:

• Bacteria from a urinary tract or prostate infection that spreads
• Viral infections, such as the mumps virus
• Urine in the epididymis (chemical epididymitis)
• Groin injury
• Tuberculosis infection (rare)

Since STDs are a common cause of epididymitis, any sexual behavior that can lead to contracting an STD increases the chances of also developing epididymitis. Such behavior includes having sex with a partner that has an STD and unprotected sex.

Other risk factors include:

• History of prostate or urinary tract infections
• History of medical procedures that affect the urinary tract
• An uncircumcised penis
• An anatomical abnormality of the urinary tract
• Prostate enlargement

To determine whether you have epididymitis, your doctor will check for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. A rectal examination may also be done to check for prostate enlargement or tenderness.

Your doctor may suggest testing for STDs and an ultrasound to rule out testicular torsion.

Treatment

Bacterial epididymitis is typically treated with antibiotics. If it’s found that the condition was caused by an STD, your doctor will also recommend that your sexual partner be treated.

You should start to feel better within 48 to 72 hours of starting the antibiotic. Rest will also be required, as well as supporting the scrotum and taking pain medication to relieve discomfort.

In some cases, when an abscess has formed, surgery may be needed to drain it. In rare cases, all or part of the epididymis will need to be surgically removed.

If you suspect you have epididymitis, the Urology specialists at Kelsey-Seybold Clinic in Houston can determine the cause and provide the necessary treatment.