What is epididymitis?
Epididymitis is an inflammation of the epididymis (the structure
that is the first part of the duct draining the testis). This can
occur as the result of injury or infection.
What are the causes?
Epididymitis is caused by bacterial organisms associated with
urinary tract infection, sexually-transmitted diseases (such as
chlamydia and gonorrhoea), prostatitis (infection of the
prostate), or prostatectomy (removal of the prostate).
The risk is higher in sexually active men who are not monogamous
and do not use condoms. Men who have recently had surgery or have
a history of structural problems involving the genitals or urinary
tract are also at increased risk regardless of their sexual
behaviours.
What are the symptoms?
Epididymitis may begin with a low-grade fever and chills and a
heavy sensation in the testicle. The testicle becomes increasingly
sensitive to pressure.
The symptoms of epididymitis include scrotal pain and swelling.
The pain or swelling may be mild or severe. At times the
epididymis may become so inflamed that the patient is unable to
walk due to pain. There may be lower abdominal discomfort or
pelvic discomfort, and urination may be associated with burning or
pain. On occasion, there may be a discharge from the urethra,
blood in the semen, or pain on ejaculation. The testicle may
enlarge significantly.
How is it diagnosed?
Physical examination shows a tender and sometimes swollen testicle
on the affected side. Tenderness can usually be localised to a
small area of the testicle where the epididymis is attached.
Enlarged lymph nodes in the groin area may be present. There may
be a discharge from urinary meatus. A rectal internal examination
may reveal an enlarged or tender prostate. The following tests may
be performed:
* A urinalysis and culture
* Tests to screen for chlamydia and gonorrhoea
* A complete blood count may show leukocytosis, or increased white
blood cells
* Gram stain of urethral discharge
What is the treatment?
Medications to treat infection are prescribed. Sexually
transmitted infections require special antibiotics and the
patient's sexual partners should also be simultaneously treated.
Pain relieving medications may be required and anti-inflammatory
drugs are often prescribed.
Bedrest, with elevation of the scrotum and ice packs applied to
the area, is recommended. It is very important to have a follow-up
visit with the doctor to evaluate if the infection has completely
resolved.
* Antibiotic therapy
* Analgesics for pain control
* Supportive care
* Scrotal elevation and support
* Ice pack
Epididymitis usually resolves with appropriate antibiotic therapy,
without any damage to sexual or reproductive abilities. Recurrence
of the infection is fairly common.
Infrequently, chronic epididymitis may develop and surgery may be
necessary. Although uncommon, infertility may result from chronic
epididymitis.
How is it prevented?
Complications from epididymitis may be prevented by early
diagnosis and adequate treatment of the infection. Preventive
antibiotics are frequently given at the time of operation in which
the patient is at increased risk for epididymitis. Safer sexual
practices (monogamous relationships, use of barriers such as
condoms) may be helpful in preventing those cases of epididymis
associated with sexually-transmitted diseases.
Epididymitis is can be caused by bacteria
Preventative Health
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