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The Epididymis  
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Copyright © Nucleus Medical Media, Inc.

Definition  

Acute epididymitis is an inflammation of the epididymis. This is a structure that surrounds and attaches to each testicle. It is shaped like a tube. The epididymis helps transport and store sperm cells.

Chronic epididymitis causes discomfort or pain in the epididymis. It can last for three months or longer. This type is less common.

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Causes  

This condition is most often caused by a bacterial infection. For example:

Other causes include:

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Risk Factors  

Only men can develop this condition. Risk factors include:

  • Age: 15-30 (sexually transmitted bacteria is a common cause)
  • Age: over 60 (urinary tract infections are a more frequent cause)
  • Infection of the genitourinary tract—urethra, bladder, kidney, prostate, or testicle
  • Narrowing of the urethra
  • Use of a urethral catheter
  • Infrequent emptying of the bladder
  • Recent surgery or instrumentation of the genitourinary tract—especially prostate removal
  • Birth defects of the genitourinary tract
  • Unprotected sex
  • Disease that affects the immune system

Children and newborns can get epididymitis. It is not necessary to have a urinary tract infection.

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Symptoms  

Symptoms usually develop within one day. These include:

  • Pain in the testicles
  • Sudden redness or swelling of the scrotum
  • Hardness, a lump, and/or soreness in the affected testicle
  • Tenderness in the nonaffected testicle
  • Groin pain
  • Chills
  • Fever
  • Inflammation of the urethra
  • Pain during intercourse or ejaculation
  • Pain and/or burning during urination
  • Increased pain while having a bowel movement
  • Lower abdominal discomfort
  • Discharge from the penis
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Diagnosis  

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

  • Urinalysis
  • Urine culture
  • Culture or other test of discharge from penis
  • Blood tests

Images may be taken of your scrotum. This can be done with ultrasound.

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Treatment  

Treatment is essential to prevent the infection from worsening. Treatment may include:

  • Bed rest—This keeps the testicles from moving and promotes healing. You may need bed rest until the swelling goes away.
  • Antibiotics—You will be given antibiotics to treat a bacterial infection. Many cases of epididymitis are caused by sexually transmitted bacteria. Chlamydia is one of the most common. If you have an STD , your partner(s) will also need treatment.
  • Oral anti-inflammatory medication—This includes drugs like ibuprofen to help reduce swelling.
  • Scrotal elevation and support—You may need to wear an athletic supporter for several weeks.
  • Hot baths—Taking baths can ease the pain and help relieve swelling.
  • Surgery—May be needed in severe cases that keep coming back.
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Prevention  

The following steps can help decrease your risk:

  • Practice safe sex. Protect yourself from STDs by using condoms .
  • Empty your bladder as soon as you feel the need.