What is Epididymitis?

Epididymitis means there is inflammation or pain of the epididymis, which is the coiled tube located on the back, inside of the testicle. This swelling can be acute (sudden) or chronic (long-term), and most of the time is caused by a bacterial infection or also by a sexually transmitted infection. Chronic epididymitis usually develops over a day or two with symptoms being less severe than acute epididymitis. Also, urinary symptoms will not be present with chronic epididymitis as they are with an acute condition. Epididymitis can be diagnosed in males of all ages, but mostly in adult-aged males.


Symptoms of Epididymitis

Symptoms of epididymitis may include (but are not limited to):

  • A swollen, red or warm scrotum
  • Testicle pain and tenderness, usually on one side
  • Painful urination or an urgent or frequent need to urinate (not common in chronic cases)
  • Discharge from the penis
  • Pain or discomfort in the lower abdomen or pelvic area
  • Blood in the semen
  • Fever (less common)

STI’s

Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.

Other infections

Bacteria from a urinary tract or prostate infection might spread from the infected site to the epididymis. Also, viral infections, such as the mumps virus, can result in epididymitis.

Urine in the epididymis (chemical epididymitis)

This condition occurs when urine flows backward into the epididymis, possibly because of heavy lifting or straining.

Trauma

A groin injury can cause epididymitis.

Tuberculosis

Rarely, epididymitis can be caused by tuberculosis infection.


Diagnosing Epididymitis

Your urologist will request to test a urine sample at your visit. In acute epididymitis the urine is often infected. In chronic epididymitis the urine typically is not infected. Your urologist may also want to look more closely at the testicle by requesting an ultrasound image. Ultrasound is a non-invasive and radiation-free test that uses sound waves to make a picture. An ultrasound can look at the blood flow in the epididymis, provide a picture to the inside of the testis and see other changes in that area of the body.

Treating Epididymitis

For acute epididymitis, the treatment usually includes a 1-2 week course of antibiotics. Your urologist will need to use the culture from the urine sample to best match the type of antibiotic to prescribe with the type of bacteria found in the urine. To help blood flow, lower swelling and pain, and increase healing, try to elevate the scrotum above the heart. Getting enough rest, drinking lots of fluids as well as icing the scrotum intermittently will also be helpful for a faster recovery.