Epididymitis is the inflammation of the epididymis tube located at the back of each testicle, which collects and stores sperm.
Epididymitis (eh-pih-dih-duh-MY-tis) is a condition of the male genitalia. It is an inflammation or swelling of the tube, called the epididymis, that connects the testicle with the vas deferens (the duct that carries sperm from the testicle to the urethra). The main cause of epididymitis is a bacterial infection that begins in the urethra (the tube that carries urine from the bladder), the prostate, or the bladder. In young heterosexual men, epididymitis is usually caused by the sexually transmitted diseases * gonorrhea * or chlamydia * . In children, older men, and homosexual men, epididymitis is usually caused by Escherichia coli (E. coli), which is an organism found in the colon and rectum. The E. coli infection usually starts as an infection of the prostate gland that moves into the urinary tract.
Uncircumcised * males between the ages of 19 years and 35 years are most at risk for epididymitis. Sexual intercourse with more than one partner and not using a condom can increase the risk of getting epididymitis. Problems with the anatomic structure of the urethra and urinary tract can increase a man's risk for epididymitis, as can a history of recent surgery in the genital area. Men who have to use a urethral catheter (a tube inserted to remove urine from the bladder) are also at increased risk for epididymitis.
Epididymitis is fairly common, affecting about 1 in 1,000 men annually. Acute cases of the disease are believed to be the cause of more than 600,000 doctor visits each year in the United States alone. It most commonly occurs in men between the ages of 20 and 59.
The bacteria that cause epididymitis can be transmitted through sexual contact. It is recommended that anyone who has symptoms of epididymitis refrain from all forms of sexual contact until consulting a doctor.
Early signs of epididymitis may include low-grade fever, chills, and a feeling of heaviness in the area of the testicles. Sensitivity to pressure and pain occur as the condition continues.
Other signs of epididymitis include the following:
Healthcare providers obtain a complete medical history from patients and ask specific questions about toileting hygiene, sexual contacts, and use of a condom, as appropriate. A physical examination is conducted to observe any swelling, redness, or discharge from the penis. A rectal examination may be done, which may show an enlarged or tender prostate.
Laboratory examination of blood and urine samples are conducted to determine whether infectious organisms are present. Specific tests may be done for gonorrhea and chlamydia. Specialized studies, including ultrasound and a testicular scan, may be done.
Patients may be referred to a urologist, who has advanced knowledge and experience in male genital and urinary problems.
Epididymitis is usually treated with antibiotics * specific to the organism found in the urine and blood. If a patient has a sexually transmitted disease such as gonorrhea or chlamydia, his sexual partner(s) * must also be treated. In many states, sexually transmitted diseases must be reported to the local health department by the healthcare provider.
Ice packs placed on the scrotum and lying down with the scrotum elevated may help to relieve the pain associated with epididymitis.
Over-the-counter medications * such as acetaminophen or aspirin may be recommended to relieve the pain and treat the fever.
The best prevention against epididymitis caused by sexual intercourse is to use a condom whenever having sex. A man who must use a urinary catheter to drain urine from his bladder can prevent epididymitis by maintaining the sterility of the catheter.
See also Orchitis • Scrotal Swelling • Sexually Transmitted Infections (STIs): Overview • Testicular Torsion • Urinary Tract Infection
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* sexually transmitted disease (STD) is a disease that is transmitted through any type of sexual intercourse, including vaginal, rectal, or oral sex.
* gonorrhea (gah-nuh-REE-uh) is a sexually transmitted disease (STD) spread through all forms of sexual intercourse. The bacteria can also be passed from an infected mother to her baby during childbirth. Gonorrhea can affect the genitals, urethra, rectum, eyes, throat, joints, and other tissues of the body.
* chlamydia (kla-MIH-dee-uh) are microorganisms that can infect the urinary tract, genitals, eye, and respiratory tract, including the lungs.
* uncircumcised is the natural form of the penis at birth, with foreskin covering the head of the penis.
* ejaculation is the ejection or discharge of semen from the penis.
* antibiotic (an-tie-by-AH-tik) is a drug that kills or slows the growth of bacteria.
* sexual partner is any person who has sexual relations with another, regardless of whether consent has been given, and by any sexual activity including vaginal, rectal, or oral sex. also called sexual contact.
* over-the-counter medications are medications that can be bought without a doctor's prescription.