Epididymitis
Have you heard about epididymitis? What about orchitis? Epididymitis is inflammation of the epididymis. The epididymis is the coiled tube that lies on and around each testicle. It functions in the transport, storage and maturation of sperm cells that are produced in the testicles. The epidiymis connects the testicles with the vas deferens -the tubes that carry sperm-. Orchitis is inflammation of the testicle. It comes on suddenly and subsides with treatment.
Treatment for epididymitis includes antibiotics, bed rest, ice to reduce swelling, the use of a scrotal supporter and anti-inflammatory medicines.
The use of condoms during sex can help prevent epididymitis caused by chlamydia. If left untreated, epididymitis can produce scar tissue, which can block the sperm from leaving the testicle. This can cause problems with fertility, especially if both testicles are involved or if the man has recurring infections.
Causes
Epididymitis often is caused by infection or by the sexually transmitted disease chlamydia.
In children who haven't reached puberty, the infection usually starts in the bladder or kidney and then spreads to the testicle.
In sexually active men, the most common infection causing epididymitis is a sexually transmitted disease such as gonorrhea or chlamydia infection. These infections start in the urethra, causing urethritis, which can then move into the testicle.
In men over 40 years of age, the most common cause is bacteria from the urinary tract. Other causes: bladder outlet obstruction due to enlargement of the prostate; partial blockage of the urethra; or recent catheterization of the urethra.
In any of these cases, the original infection may not cause symptoms, and the first sign of a problem may be epididymitis. Epididymitis is occasionally due to causes other than infection. For instance, when urine flows backward from the urethra to the epididymis -this occurs with heavy lifting-, and then the urine causes inflammation without infection.
In most cases of orchitis, the testicle is inflamed due to the spread of a bacterial infection from the epididymis.
Symptoms
Symptoms occur not only from the local infection, but also from the original source of the infection. Symptoms of epididymitis include:
scrotal pain and swelling
in severe cases, the infection can spread to the adjacent testicle
fever
abscess -collection of pus-
urethral discharge and urethral pain or itching -from urethritis-
pelvic pain and urinary frequency -from infection of the bladder: cystitis-
fever, perineal pain, urinary frequency -from infection of the prostate: prostatitis-
fever and flank pain -from infection of the kidney: pyelonephritis-
swelling, tenderness, redness, firmness and warmth of the skin may also accompany the pain. The entire scrotum can swell up with fluid -hydrocele-.
In some cases, pain in the scrotum from the local infection is the only noticeable symptom. The pain starts at the back of one testicle but can soon spread to the entire testicle, the scrotum and occasionally the groin.
Treatment
The use of condoms during sex can help prevent epididymitis caused by chlamydia. If left untreated, epididymitis can produce scar tissue, which can block the sperm from leaving the testicle. This can cause problems with fertility, especially if both testicles are involved or if the man has recurring infections.
Treatment for epididymitis includes:
- at least two weeks of antibiotics
- bed rest
- ice to reduce swelling
- the use of a scrotal supporter
- anti-inflammatory medicines
Most cases can be treated with oral antibiotics as an outpatient. Cases with intractable pain, vomiting, high fever or severe illness, may require admission to the hospital. Therapy for epididymitis includes bed rest for one to two days with elevation of the scrotum. The aim is to get the inflamed epididymis above the level of the heart.
This improves blood flow out of the testicle, which promotes rapid healing and reduces swelling and discomfort. Application of ice might also be of assistance and, intake of plenty of fluids. Anti-inflammatory drugs are useful since they not only relieve pain but also reduce the inflammation that is the cause of the pain.
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