Epididymitis is swelling (inflammation) of the epididymis, the tube that connects the testicle with the vas deferens.
Causes, incidence, and risk factors
Epididymitis is most common in young men ages 19 – 35. It is a major cause of hospital admissions in the military.
Epididymitis is usually caused by the spread of a bacterial infection from the urethra, prostate, or the bladder. The most common infections that cause this condition in young heterosexual men are
Mycobacterium tuberculosis (TB) can cause epididymitis. Other bacteria (such as Ureaplasma) may also cause the condition.
Another cause of epididymitis is the use of a medication called amiodarone, which prevents abnormal heart rhythms.
The following increase the risk for epididymitis:
Recent surgery or a history of structural problems in the urinary tract
Regular use of a urethral
Sexual intercourse with more than one partner and not using condoms
Epididymitis may begin with a low-grade
Other symptoms include:
Blood in the semen
- Discharge from the urethra (the opening at the end of the penis)
- Discomfort in the lower abdomen or pelvis
- Lump in the testicle
- Pain during ejaculation
- Pain or burning during urination
scrotal swelling(epididymis is enlarged)
- Tender, swollen groin area on affected side
Testicle painthat gets worse during a bowel movement
Signs and tests
Physical examination shows a red, tender, and sometimes swollen lump (mass) on the affected side of the scrotum. Tenderness is usually in a small area of the testicle where the epididymis is attached.
There may be
These tests may be performed:
- Complete blood count (
- Testicular scan (nuclear medicine scan)
Urinalysisand culture (you may need to give several specimens, including initial stream, mid-stream, and after a prostate massage)
- Tests for chlamydia and gonorrhea
It is important to distinguish this condition from
Your health care provider will prescribe medications to treat the infection. Sexually-transmitted infections require specific antibiotics. Your sexual partners should also be treated. You may need pain medications and anti-inflammatory medications.
The treatment for epididymitis caused by the medication amiodarone is a lower dose or change in the medication.
Bed rest, while elevating the
Epididymitis usually gets better with antibiotic treatment. There usually is no reduction in sexual or reproductive abilities. However, the condition may return.
If not treated, or in some other cases, the condition can become long-term (chronic). In chronic cases, there is usually no swelling, but there is pain.
Abscessin the scrotum
Fistulaon the skin of the scrotum (cutaneous scrotal fistula)
Death of testicular tissue due to lack of blood (testicular infarction)
Acute pain in the scrotum is a medical emergency. It needs to be checked out by a health care provider immediately.
Calling your health care provider
Call your health care provider if you develop symptoms of epididymitis. Go to the emergency room or call the local emergency number (such as 911) if you have severe testicle pain suddenly or after an injury.
You can prevent complications from epididymitis by getting diagnosed early, and by treating any infections.
Your doctor may prescribe antibiotics before a surgery that increases the risk for epididymitis. Practicing safe sex (having intercourse with only one partner at a time, using condoms) may help prevent epididymitis caused by sexually-transmitted diseases.