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Epididymitis is inflammation of the epididymis, causing pain in the scrotum. It is usually caused by a bacterial infection and treated with antibiotics, but can also be caused by other conditions. Recurrence is possible, and in severe cases, the epididymis may need to be removed.
The epididymis is a hollow tube located at the back of the testicles through which sperm passes. In some cases, this tube can become irritated and inflamed causing a condition called epididymitis. This inflammation can result in extreme pain in the scrotum and can be misdiagnosed as testicular torsion. The treatments for the two conditions are very different, so an appropriate diagnosis is needed to determine the appropriate cure.
Some other conditions can also cause pain in this region. Medical professionals evaluating patients for epididymitis usually want to rule out testicular cancer, the presence of benign cysts, and hernias. Regular testicular self-exam can make diagnosis easier, as men are likely to notice the presence of cysts or lumps on the testicles.
Usually, this inflammation is caused by a bacterial infection. Most commonly, urinary tract infections can cause bacteria to spread to the epididymis. Other causes of this condition include the STDs gonorrhea and chlamydia. When someone sees a doctor about this problem, it’s important to disclose recent sexual history, particularly where safe sex hasn’t been practiced or when the person has had multiple sexual partners.
Because the usual cause is bacterial, treatment almost always includes antibiotics. Men may also be asked to use cold packs on the scrotum and elevate the pelvis to reduce swelling. Patients are usually revisited by a healthcare professional after antibiotic treatment to make sure that the swelling is gone.
In some cases, the pain becomes very severe and can extend to pain in the lower abdomen. When epididymitis is not caused by an infection but is caused by conditions that cause the nerves to swell, treatment can be more complex and difficult. Some cases may require the use of injected steroids to quickly reduce significant swelling.
On some occasions, patients may require hospitalization to administer a pain-relieving agent, which can offer long-term pain relief. This medication is called a cord block and can often keep the person from feeling pain for a couple of months, usually long enough for the condition to go away. Sometimes, oral pain medications such as codeine or hydrocodone are also effective in pain relief. Anti-inflammatories such as ibuprofen can often be helpful in temporary relief of symptoms.
People with bacterial epididymitis usually don’t have symptoms recur, unless they have another causative bacterial infection. Those with non-infectious cases may find that the condition can recur. While this condition can often be completely cured, some find that it remains acute and choose to have the epididymis removed. This is usually a method of last resort, as it causes infertility. For some men, however, the sacrifice is well worth the resulting pain relief.
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