Epididymitis is inflammation of the sperm-carrying tube in the rear of your testicle. The swelling can cause severe pain in your testicle and scrotum.
What Is Epididymitis?
Epididymitis is an inflammation of the epididymis that produces discomfort or pain in the scrotum, testicles, or epididymis. The epididymis is a coiled tube located behind each testicle. It stores and transports sperm. Since it directly affects sperm quality and pathways, a semen analysis is often recommended after recovery to check for potential changes in fertility.
Inflammation anywhere on your body can be painful and uncomfortable. It can be particularly upsetting when it affects a sensitive place. However, inflammation is your body's way of notifying you something is wrong, and you should consult a doctor. Experts will do their best to determine what is causing your pain, treat you quickly, and put your mind at ease.
Also Read: Understanding Semen Analysis: Procedure and Results
Kinds Of Epididymitis
There are two forms of epididymitis:
- Acute Epididymitis (occurs suddenly): This is when your symptoms appear rapidly and develop. Acute epididymitis is mainly caused by a bacterial infection.
- Chronic Epididymitis: This is when you have discomfort or pain for six weeks or more. Discomfort or pain may subside and then return. Symptoms are typically less severe than those associated with acute epididymitis.
Symptoms Of Epididymitis
Epididymitis symptoms can include:
- Pain in your scrotum, which may spread to the rest of your groin. The discomfort could be on one or both sides and range from minor to severe.
- Swollen testicles.
- Fever with chills.
- Dysuria, which is experiencing the sensation of pain during urination.
- Blood in your sperm (hematospermia).
Causes of Epididymitis
Bacterial infection is the leading cause of acute epididymitis. The most prevalent cause of epididymitis in those under the age of 35 is sexually transmitted infections (STIs), such as gonorrhoea or chlamydia.
If you are over 35, the most common cause of epididymitis is the backflow of infected urine down the ejaculatory tube to the epididymis. The most prevalent bacteria associated with this is E. coli, which can sometimes impact sperm count and quality. Understanding low sperm count causes can help you manage potential long-term impacts.
Epididymitis can also be caused by other infections, such as the mumps virus or, in rare cases, tuberculosis.
Also Read: Causes and Treatments for Low Sperm Count in Men
Epididymitis Diagnosis
A doctor will ask you about your symptoms and examine your scrotum for tendeess or lumps. They may also prescribe tests like:
- Urine analysis (pee test): They will test for microorganisms in a sample of your urine.
- Blood testing: They will obtain a blood sample and look for symptoms of infection.
- Bacterial swabs: They will insert a swab into your urethra and examine it for STI infections (bacteria or viruses), which may necessitate treatment.
- Ultrasound: In rare situations, they may take photographs of your scrotum to assist in epididymitis diagnosis.
Epididymitis Treatment Options
The cause of epididymitis determines how it is treated. Depending on the diagnosis, doctors will choose from the following protocols:
Epididymitis Treatment Summary
| Type of Epididymitis | Common Causes | Recommended Antibiotics / Treatment |
|---|---|---|
| Bacterial Epididymitis (under 35) | Sexually transmitted infections (STIs) like Gonorrhoea or Chlamydia | Doxycycline, Ciprofloxacin, Levofloxacin |
| Bacterial Epididymitis (over 35) | Backflow of infected urine (commonly E. coli bacteria) | Doxycycline, Ciprofloxacin, Levofloxacin, Trimethoprim-sulfamethoxazole |
| Tuberculosis Epididymitis | Spread of Tuberculosis (TB) bacteria to epididymis | Isoniazid, Pyrazinamide, Rifampin, Ethambutol, Rifapentine |
| Amiodarone Epididymitis | Heart arrhythmia medication (Amiodarone) | Reducing dosage or switching medication under medical supervision |
Severe Cases and Surgical Options
In severe circumstances, a surgeon may have to remove one or both of your epididymides (epididymectomy) or testicles (orchiectomy). This is rare and is only performed when infections do not respond to antibiotics. Such surgical removals can impact sperm release, potentially leading to fertility challenges like azoospermia.
Also Read: Azoospermia: Symptoms, Causes, and Treatments
How Long Does Epididymitis Take to Heal?
It depends on the cause of epididymitis:
- Bacterial Illness: In most cases, you should feel better a few days after starting antibiotics. However, swelling can take weeks to fully resolve. After finishing your antibiotic prescription, you may experience discomfort or swelling for weeks or even months.
- Tuberculosis Epididymitis: This can take up to nine months to resolve with specialized antituberculosis medical care.
- Amiodarone Epididymitis: If the arrhythmia medicine amiodarone is the cause, you should feel better soon after your doctor reduces your dose or switches you to an alteative prescription.
- Post-Surgery Recovery: In extremely rare cases where a surgeon removes your epididymides or testicles, you may experience temporary pain right after surgery due to swelling, and it may take several weeks to recover. This is normal and doesn't mean the surgery was ineffective.
