Epididymitis is a medical condition that is recognized as inflammation of the coiled tube that collects sperm from the testicles and passes the sperm to the vas deferens, also called the epididymis. The condition is most common among men between the ages of 14 and 35. Here is an overview of what you should know about epididymitis including symptoms, causes, risk factors, diagnosis, and treatment.
Symptoms for acute or sudden onset epididymitis include:
- Testicular pain
- Swollen or tender scrotum that may be accompanied by redness or warmth of the skin
- Urethral pain
- Frequent or urgent need to urinate
- Painful or burning sensation when urinating
- Flank or abdominal pain or discomfort
Symptoms for chronic epididymitis develop over a couple days. Although treatment can help relieve symptoms, it is possible for the condition to recur.
Symptoms are not as severe as acute or sudden onset epididymitis. Typically, mild discomfort and pain in the scrotum will be experienced with chronic epididymitis, but urinary symptoms are not present.
There are several causes of epididymitis, including:
- STIs: The most common cause of epididymitis in young men are sexually transmitted infections: gonorrhea and chlamydia.
- Other infections: For boys and men who aren't sexually active, epididymitis can be the result of a bacterial infection that is non-sexually transmitted. If a urinary tract or prostate infection is present, bacteria can spread from the infected site to the epididymis.
- Amiodarone (Pacerone): Inflammation of the epididymis can be caused by this heart medication.
- Urine in the epididymis (chemical epididymitis): This condition is the result of urine flowing backward into the epididymis. Heavy lifting or straining can be a cause for this condition.
- Trauma: Injury to the groin can cause epididymitis.
- Tuberculosis: Although rare, epididymitis can be caused by tuberculosis.
The following factors increase the risk for epididymitis:
- Sex with a partner who has an STI
- Sex without a condom
- A personal history of STIs
- Past prostate or urinary tract infections
- Past medical procedures that affect the urinary tract (insertion of a urinary catheter or scope into the penis)
- An uncircumcised penis or an anatomical abnormality of the urinary tract
- Prostate enlargement, which increases the chance of bladder infections and epididymitis
If you are experiencing symptoms, you will need to see a urologist who will perform a series of diagnostic tests that can include:
- Urinalysis or a urine culture to test for a bacterial infection
- Screening for sexually transmitted diseases
- Ultrasound imaging to measure blood flow and is used to check for another testicular torsion, or twisting of the spermatic cord, which also causes sudden testicular pain.
Acute epididymitis caused by a bacterial infection or sexually transmitted disease, will be treated with oral antibiotics to clear up the infection.
Effective ways for reducing pain and discomfort, especially in chronic epididymitis include:
- Bed rest for one to two days.
- Elevation of the scrotum to help improve blood flow. While lying in bed, place a rolled up towel under your scrotum to elevate.
- Non-steroidal anti-inflammatory medications can be taken for pain that occurs due to chronic epididymitis