EPIDIDYMITIS

General Information

DEFINITION--An inflammation and infection of the epididymis, an oblong structure attached to the upper part of each testis.

BODY PARTS INVOLVED--Epididymis.

SEX OR AGE MOST AFFECTED--Males between puberty and old age.

SIGNS & SYMPTOMS

• Enlarged, hardened, painful testicle.
• Fever.
• Tender scrotal contents.
• Tenderness of the second testicle (sometimes).
• Acute urethritis (often).

CAUSES--Usually a complication of a bacterial infection elsewhere in the body, such as: gonococcal infection of the urethra; prostate infection; or bladder or kidney infection. Epididymitis may also complicate an infection of the scrotum or be caused by scrotal injury.

RISK INCREASES WITH

• Recent illness, especially acute or chronic prostatitis, urethritis or urinary-tract infection.
• Urethral stricture.
• Indwelling urethral catheter.

HOW TO PREVENT

• Use condoms during intercourse to protect from venereal disease. Don't engage in sexual activity with persons who have venereal disease.
• Avoid urethral catheters if possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as urinalysis and culture of prostate secretions, to identify the cause.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• An exploratory operation to make a firm diagnosis and save the testicle (rare).
• Surgical procedure may be necessary for severe cases not responding to antibiotics (rare).

POSSIBLE COMPLICATIONS

• Constipation (sometimes) because bowel movements aggravate pain.
• Sterility or narrowing and blockage of the urethra if the epididymitis involves both testicles. This requires surgery.

PROBABLE OUTCOME--Usually curable with treatment. Pain usually resolves in 1-3 days, but complete healing may take weeks or months.

How To Treat

GENERAL MEASURES--

• Support the weight of the scrotum and tender testicles. Roll a soft bath towel and place it between the legs under the inflamed area.
• Apply an ice bag to the inflamed parts to help reduce swelling and relieve pain. Don't use heat.
• Wear an athletic supporter or two pairs of athletic briefs when you resume normal activity.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection.
• Ibuprofen or acetominophen for mild pain; or stronger pain drugs for moderate to severe pain.
• Stool softeners.

ACTIVITY--Rest in bed until fever, pain and swelling improve. Don't engage in sexual intercourse Wait at least 1 month after all symptoms disappear before resuming sexual relations.

DIET--

• Don't drink alcohol, tea, coffee or carbonated beverages. These irritate the urinary system.
• Eat natural laxative foods, such as prunes, fresh fruit, whole-grain cereals and nuts, to prevent constipation.

Call Your Doctor If

• You have symptoms of epididymitis.
• Pain is not relieved by measures outlined above.
• You develop fever.
• You become constipated.
• Symptoms don't improve within 4 days after treatment begins.