Definition
Epididymitis is an inflammation of the epididymis, the tubular structure that connects the testicle with the vas deferens.
Symptoms
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Definition
Epididymitis is an inflammation of the epididymis, the tubular structure that connects the testicle with the vas deferens.
Causes
Acute epididymitis causes swelling of the scrotum, pain in the testicles, and sometimes a fever of up to 6 weeks duration or less (usually with a gradual onset over several days).
If not treated, or in some other cases, the condition can become chronic. In chronic cases, there is usually no swelling, but simply pain.
The incidence is approximately 600,000 cases per year. The highest prevalence is in young men 19 to 35 years of age. The disorder is a major cause of hospital admissions in the military (causing approximately 20% of admissions).
Epididymitis is usually caused by spread of infection from the urethra or the bladder. The most common organisms involved in the condition in young heterosexual men are ...
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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 medications may be required and anti-inflammatory medications are often prescribed.
Bed rest, 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 your health care provider to evaluate whether the infection has completely resolved.
Possible Complications
Complications include testicular infarction, scrotal abscess, cutaneous scrotal fistula, chronic epididymitis and infertility.
Acute scrotal pain is a true medical emergency with serious consequences -- immediate medical evaluation is critical.
Outlook (Prognosis)
Epididymitis usually resolves with appropriate antibiotic therapy, without any damage to prior sexual or reproductive abilities. Recurrence is fairly common.
Prevention
Complications from epididymitis may be prevented by early diagnosis and adequate treatment (plus reporting if applicable) of the infectious diseases associated with it. Prophylactic (preventive course) antibiotics are frequently given at the time of surgeries in which the patient is at increased risk for epididymitis. Safer sexual practices (monogamous relationships, use of barriers such as condoms and similar practices) may be helpful in preventing those cases of epididymitis associated with sexually-transmitted diseases.
Exams and Tests
Physical examination shows a red, tender, and sometimes swollen mass on the affected hemi-scrotum. Tenderness is usually localized to a small area of the testicle where the epididymitis is attached.
Enlarged lymph nodes in the groin area (inguinal nodes) may be present. There may be a discharge from penis. A rectal examination may reveal an enlarged or tender prostate.
These tests may be performed:
- A urinalysis and culture (the provider may request several specimens including: initial stream, mid-stream, and after a prostate massage)
- Tests to screen for Chlamydia and gonorrhea
- CBC (complete blood count)
- Doppler ultrasound to rule out testicular torsion -- hypoechoic region may be visible on the affected side as well as increased blood flow or scrotal abscess
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