Epididymitis

GENERAL INFORMATION:

What is epididymitis? Epididymitis is inflammation (pain and swelling) of your epididymis. The epididymis is a long curled tube inside your scrotum (sack of skin under your penis). Each tube is found at the back of your testicle (egg-shaped organ). It stores and carries sperm from your testicles to your penis. Epididymitis usually only occurs in one testicle, but may also occur in both. It may be an acute (short-term) or chronic (long-term) condition. Acute epididymitis lasts for six weeks or less and becomes chronic if it lasts longer than three months.

What causes epididymitis?

• Infection: The condition may occur with sexually and non-sexually transmitted infections. Germs, such as bacteria and fungi (yeast) are more common causes of the infection. Viruses and parasites (small living creatures) may also cause the infection, but are less common. Sexually transmitted infections (STI) are diseases spread by having sex with an infected partner. An infection in your bladder or prostate may also spread to your epididymis.
  
  
• Medicine: Certain medicines may attack the tissue that lines your epididymis causing pain and swelling. This is most common with a medicine used to correct abnormal heartbeats.
  
  
• Other medical problems: Medical problems that cause swelling of your blood vessels and abnormal tissue growths may cause the condition. Ask your caregiver for more information about these types of conditions.
  
  
• Trauma: An injury to your scrotum may cause epididymitis. Putting objects, such as a catheter, into your urethra (tube that drains urine) or bladder may cause the condition.

What increases my risk of having epididymitis?

• Medical problems: Having diabetes or a weak immune (body defense) system increases your risk for this condition.
  
  
• Risky sexual activity: This includes having multiple sex partners, unprotected (not using condom) sex, and anal sex. Risky sexual activity increases your risk of having an STI which may cause the condition.
  
  
• Urinary tract problems: Any problem that causes your urine to flow backwards may lead to the condition. This may include a block along the urinary tract, an enlarged or cancerous prostate, and a narrowed urethra. The prostate gland is a small walnut-shaped organ that helps make semen. Repeated urine infections may also increase your risk of having this condition.
  
  
• Vasectomy: This is a surgery done to cut the tube that carries sperm from your epididymis to your penis. Epididymitis may occur if the cut tube, or blood vessels and nerves around it become inflamed.

What are the signs and symptoms of epididymitis? You may have pain in your scrotum, on one or both sides. The pain may worsen slowly over a period of hours to days. Pain may spread to the same side of your body as the inflamed epididymis. Pain may reach your lower abdomen (stomach) and flank (back area between your last rib and hip) area. You may also have any of the following:

• A burning feeling when you urinate, or having to pass urine more than usual.
  
  
• Discharge coming out of your penis, or blood in your semen.
  
  
• Fever.
  
  
• Muscle or joint pains.
  
  
• Nausea (stomach) and vomiting (throwing up).
  
  
• Pain while having sex, or trouble having or keeping an erection. An erection is when the penis gets hard.
  
  
• Scrotum that is red, swollen and warm to touch. A lump may also be felt in your scrotum.

How is epididymitis diagnosed?

• Your caregiver will take your health history and details about your condition. He will need to know what your symptoms are and how long you have had them. Tell him if you have had an injury or trauma to your penis and scrotum before your symptoms started. Tell him about any activities, diseases, treatments, or medical procedures you have had. Your caregiver may also ask about your sexual partner to learn if you are at risk for an STI.
  
  
• Your caregiver will check your penis and scrotum to look and feel for anything abnormal. He may shine a light through your scrotum to see if fluid has pooled around your testicle. Your caregiver may also check if your prostate is big by inserting a gloved finger into your anus. He will also check other parts of your body, including your chest and abdomen. This will help him look for other problems that may be causing your symptoms. You may need any of the following tests:
  
  
  • Lab tests: These include tests to check what germ may be causing your condition. A sample of your blood or urine may be taken. If you have discharge coming from your penis, it may also be used as a sample. The sample will be sent to a lab for tests.
    
    
  • Ultrasound: This test lets your caregiver see and check for problems inside your scrotum. Sound waves are used to show pictures of your scrotum on a TV-like screen. Your caregiver will check for problems such as bleeding, lumps, and abnormal blood flow .
    
    
  • Nuclear scan: For this test, you will be given a small amount of radioactive material into your blood. Special cameras will then be used to look for areas of your testicles that have more blood flow.
    
    
  • Surgery: Your caregiver may need to open your scrotum to look for the cause of your epididymitis. Tissue samples may be taken and sent to a lab for tests.

How is epididymitis treated? Your treatment will depend on what caused your condition. Before using any over-the-counter (OTC) treatments, see your caregiver. Some treatments may make your condition worse. If you have an STI, your sex partner may also need treatment. Do not have sex again until your caregiver says it is OK. Treatment may include any of the following:

• Medicines to treat infection:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antifungal medicine: This medicine helps kill fungus that can cause illness.
  
  
• Other medicines:
  
  
  • Anti-inflammatory medicine: This medicine may help decrease and prevent swelling. Common anti-inflammatory medicines used for treatment include steroids and non-steroidal anti-inflammatory medicines (NSAIDs). NSAIDs may also help decrease pain and a high body temperature (fever). This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
    
    
  • Pain medicine: You may be given medicine to take away or decrease your pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as your caregiver says. Do not wait until the pain is bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell your caregiver if the pain medicine does not help, or if your pain comes back too soon.
  
  
• Surgery: You may need surgery if your condition worsens or becomes chronic. You may also need surgery if other treatments have failed. Surgery to remove your epididymis or testicle may be done to treat your condition. You may also need surgery to treat a problem that is causing your condition. This includes surgery to correct a urinary tract problem.

What problems may happen if I have epididymitis? If epididymitis is left untreated, more serious problems may occur. You may have increased pain that cannot be controlled. Germs causing your infection may enter your tissues and cause an abscess (collection of pus). The infection may also spread to other parts of your body. An infection of your blood will make you very sick and may even lead to death. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

How can I help treat or prevent epididymitis?

• Ice: Putting an ice pack, covered with a towel, on your swollen testicle may help decrease your symptoms. Cold causes blood vessels to get smaller which helps decrease swelling, pain, and redness. Put an ice pack on the painful area for 15 to 20 minutes every hour as long as needed. Do not sleep on the ice pack as you may get frostbite.
  
  
• Rest: Resting in bed or decreasing your activity for a period of time may help ease your pain. Rest may also help you heal faster. Ask your caregiver for more information on how long you should rest and limit your activities.
  
  
• Safe sex: Practice safe sex. Do not have sex with someone who has an STI. This also includes having oral or anal sex. Do not have sex while you or your partner is being treated for an STI. Use a latex condom every time you have sex, and make sure the condom is worn correctly. Use a new condom or proper barrier (blocking) device with each new sexual act.
  
  
• Scrotal support: Your caregiver may tell you to move and raise your scrotum to relieve the pain. While sitting, put a pillow or rolled up towel under your scrotum for support.

When should I call my caregiver? Call your caregiver if:

• You have a fever.
  
  
• Your signs and symptoms do not improve within three days of treatment, or come back after treatment.
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help? Seek care immediately or call 911 if:

• Your skin feels itchy and a rash appears after taking your medicine.
  
  
• You feel lightheaded or you have fainted (passed out).
  
  
• You have severe (very bad) testicle pain that starts suddenly or follows an injury.
  
  
• Your symptoms become worse even after starting treatment with medicine.

Where can I find more information? Contact any of the following:

• American Social Health Association (ASHA)
  P.O. Box 13827
  Research Triangle Park, NC 27709
  Web Address: http://www.ashastd.org
  

• Centers for Disease Control and Prevention
  Mailstop F07
  Atlanta, Georgia 30333
  Phone: 1-404-6393534
  Phone: 1-800-3113435
  Web Address: http://www.cdc.gov
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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