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Epididymitis

Definition


Disease: Epididymitis Epididymitis
Category: Genito-urinary diseases

Disease Definition:

Epididymis is the coiled tube at the back of the testicle that stores and carries sperm. Epididymitis is the inflammation of this tube. Its most common signs and symptoms are pain and swelling. Even though males of any age could get this disease, however, it is most common between the ages of 19 and 35. This disease is usually caused either by an STD, such as Chlamydia or gonorrhea or by a bacterial infection. Orchitis could sometimes accompany this disease, in which case the testicle also becomes inflamed.
 

Work Group:


Symptoms, Causes

Symptoms:

Depending on its cause, the signs and symptoms of epididymitis may include:

 

  • Blood in the semen
  • A lump on the testicle
  • Discharge from the penis
  • Painful intercourse or ejaculation
  • Enlarged lymph nodes in the groin called inguinal nodes
  • A tender, swollen, red or warm scrotum
  • Chills and a fever that may last up to six weeks.
  • Pain of discomfort in the lower abdomen of pelvic area
  • An urgent or frequent need to urinate, or painful urination
  • Testicle pain and tenderness, usually on one side. When having a bowel movement, the pain could get worse.

 

Usually, the signs and symptoms of this condition develop over a day or two and get better with treatment. However, when epididymitis doesn’t clear up completely or recurs, this means that it is chronic epididymitis. In some cases, the cause of chronic epididymitis can't be identified, and its symptoms could come on gradually.
 

Causes:

Some of the conditions that could cause epididymitis include:

 

Tuberculosis:

Epididymitis may be caused by tuberculosis in some cases.

 

Urine in the epididymis:

When urine flows backward into the epididymis this condition occurs, which is called chemical epididymitis. It usually occurs with straining or heavy lifting.

 

STDs:

The most common cause of epididymitis in young and sexually active men is sexually transmitted diseases, such as Chlamydia or gonorrhea.

 

Other infections:

Epididymitis is more likely to be caused by a non-sexually transmitted bacterial infection in boys, older men and homosexual men. If a man has had urinary tract infections or prostate infections, bacteria could spread from the infected are to the epididymis. Fungal infections may also cause epididymitis in some rare cases.

 

Amiodarone:

Sometimes, inflammation of the epididymis could be caused by this anti-arrhythmic medication (heart medication). When this happens, the medication will either be changed, or its dosage will be lowered.
 

Complications

Complications:

Eventually, epididymitis could cause these complications:

 

  • In some rare cases, impaired fertility
  • Shrinkage of the affected testicle (atrophy)
  • Scrotal abscess, in case the infected tissue fills with pus.
  • When left untreated, acute epididymitis causes recurrent episodes; it could also lead to chronic epididymitis.

 

Epididymo-orchitis occurs when this condition spreads from the epididymis to the testicle. The symptoms and treatments of this condition are the same as those of epididymitis.
 

Treatments:

Antibiotic medications are used to treat epididymitis that is caused by an STD or other infection. The sexual partner of someone with this condition will also need treatment. The doctor should be aware of the medications the patient is taking or if he/she has any allergies. The best treatment will be chosen depending on this information and what type of infection the patient has.

 

Although after the patient starts treatment symptoms may be relieved in two to three days, however, they should make sure to take the entire course of antibiotics prescribed. The patient should contact the doctor in case they don’t feel better in that time. To make sure that the infection has cleared up, the patient should visit the doctor for a follow-up after they've finished their medication.

 

Usually, after a few days of antibiotics, symptoms will improve. However, the patient may be prescribed another antibiotic in case their symptoms don’t improve. Further tests may be done, in case the symptoms still don’t improve, to determine whether their epididymitis is caused by something other than an STD or a bacterial infection.

 

If a pocket of pus (abscess) has formed, it may need to be drained, and in some cases, a part or all of the epididymis may need to be removed surgically. In case the epididymitis is caused by tuberculosis or underlying physical defects, surgery may be necessary.
 

Prognosis:

Not available

Expert's opinion

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