Epididymitis or inflammation of the sperm carrying tube is a consequence of infection, mostly of sexually transmitted infection (STI). According to experts like Sexologist in Islamabad and the Centers for Disease Control and Prevention, the two most common causes of epididymitis are: gonorrhea and chlamydia. There are different symptoms and treatment strategies for epididymitis; read on to know more about them:
What is epididymitis?
In the back of the testes, there is a tube called epididymis, that carries the sperms from the testes to the ejaculatory duct through the vas deferens. When there is inflammation or infection of the epididymis, this is called epididymitis. When the illness also involves the testes, the condition is called epididymo-orchitis.
What are the causes of epididymitis?
The common causes of epididymitis are related to the age group.
- Children: in teenagers younger than 14 years of age, the most common cause of epididymitis is considered the backflow of urine into the ejaculatory duct. The annual incidence of epididymitis in boys aged two to thirteen, is 1.2 per 1000.
- Sexually active men: this age group up to the age of 35 years, often experiences epididymitis as a consequence of sexually transmitted infection (STI) like gonorrhea and chlamydia. The incidence of epididymitis in this age group is 43 percent.
- Men older than 35 years: experience epididymitis due to enteric bacteria, like coli entering the epididymis through urine reflux due to bladder outlet obstruction.
- In men with HIV: acquired immunodeficiency syndrome (AIDS) due to infection by HIV puts men at risk of epididymitis due to viral and fungal invasion, including
- Other causes: general risk factors include sexual activity, motorcycle riding, prolonged sitting, strenuous physical activity, recent urinary tract surgery, obstruction of prostate or anatomical abnormalities like posterior urethral valves and meatal stenosis in prepubertal boys. Drug related epididymitis is common with the use of antiarrhythmic medication:
What are the symptoms of epididymitis?
Commonly, testicular torsion is misdiagnosed as epididymitis. This is why a thorough history and examination by a healthcare professional is mandatory. The patient of epididymitis usually presents with gradual onset of pain, with symptoms similar to urinary tract infection. The patient may complain of pain radiation to the lower abdomen. Often, there is also testicular swelling spanning over a couple of days, with concurrent fever, pain on urination and blood in urine.
Upon examination, there may be scrotal swelling and pain that gets better on elevation of the scrotum. The diagnosis of epididymitis is based on the clinical examination mostly. Other conditions that need ruling out include: testicular torsion, inguinal hernia, urinary tract infection, and testicular cancer.
What are the treatment options?
The treatment of epididymitis is dependent on the causative factor. For bacterial epididymitis the mainstay of treatment is antimicrobial agents.
For acute epididymitis, treatment is started with one to two-week course of antibiotics. Oral medication is the preferred route in uncomplicated disease. The medication commonly prescribed includes: doxycycline, trimethoprim-sulfamethoxazole, levofloxacin and ciprofloxacin. In case the inflammation and redness does not settle after a few days with the prescribed antibiotic, the healthcare provider should be contacted to switch the antibiotic or use stronger doses.
Deteriorating patient: if patient is deteriorating, with uncontrolled fever, vomiting and pain, hospital admission is mandated. Intravenous antibiotics are then given for fighting the bacterial infection, along with strong painkillers to manage the pain.
For medication related epididymitis: the causative drug is stopped or limited, upon the advice of the healthcare provider and the condition of the patient is monitored continuously.
Non-infectious epididymitis: warrants conservative treatment as per the advice of a professional like Best Sexologist in Lahore, with: rest, raising of the scrotum, icing of the area, drinking plenty of fluid and using anti-inflammatory agents like aspirin, naproxen and ibuprofen.