What do Doctors call this Condition - Epididymitis

What is this Condition?

Inflammation of the epididymis is an infection of the long, coiled duct where sperm develops in the testicles. The tube carries sperm from the testicle to the urethra. It is most common in men ages 18 to 40 and usually affects only one side of the reproductive system. If the infection is on both sides or spreads into the testicles, it can lead to sterility.

What Causes it?

Inflammation of the epididymis is most often caused by pus-generating bacteria such as staphylococci, Escherichia coli, or streptococci. Usually, these organisms spread from an established urinary tract or prostate infection through the vas deferens to the epididymis.

The inflammation may also be caused by gonorrhea, syphilis, or Chlamydia infection. Or it may follow prostate surgery or urinary catheterization .

Chemical inflammation of the epididymis (from nonbacterial causes) is brought on by injury to the tubes or irritation from urine backing up into the vas deferens. This form of inflammation is common in military recruits who may exercise for long periods with a full bladder, which causes the urine backup.

What are its Symptoms?

The person with inflammation of the epididymis may feel sudden scrotal pain and see redness and swelling. He may have extreme tenderness of the scrotum and groin (from enlarged lymph nodes in the spermatic cord), fever, chills, and general discomfort. The discomfort may cause him to waddle when he walks, in an attempt to protect the groin area.

Complications

Untreated inflammation of the epididymis can cause sterility. An infection that spreads to one or both testicles can cause a condition called orchitis that affects the testicles and decreases sperm production.

How is it Diagnosed?

The doctor may tentatively diagnose inflamed epididymis from the person’s medical history, a physical exam, and his description of symptoms. Then the doctor will order tests to confirm the diagnosis, including a white blood cell count, a urinalysis, a urine culture and sensitivity test, urethral discharge and prostatic secretion cultures, and, possibly, segmented bacteriologic localization cultures.

How is it Treated?

If you have inflammation of the epididymis, the doctor will work to combat the infection and relieve your symptoms. Treatment must begin immediately (particularly if you have inflammation in both testicles) because sterility is always a threat. Treatment includes antibiotics and analgesics, bed rest with scrotal elevation and ice packs, and sometimes surgery.

What can a Person with Inflammation of the Epididymis do?

First, take the antibiotic exactly as the doctor prescribed it, even if you feel better. Otherwise, the infection could return.

Before the antibiotics reduce the inflammation, you should remain in bed to reduce swelling and relieve pain. Use a towel-wrapped ice bag to elevate your scrotum and relieve swelling, but remove it for several minutes every hour to avoid a burn. Don’t take sitz baths or apply heat, because heat destroys sperm cells. You can start walking when your pain and swelling subside, and you should wear an athletic supporter. Avoid vigorous activity until all your symptoms disappear.

Help for Severe Pain

If you have severe inflammation, the doctor may inject the spermatic cord just above the testicle with an anesthetic, such as Xylocaine, to relieve pain. If you have a fever, consult your doctor before taking aspirin or Tylenol, because they may interfere with your therapy.

If you have Surgery

Two surgical procedures are used to treat epididymitis. Both are performed with local anesthetic and do not require a hospital stay. Both procedures also cause sterility. An epididymectomy is performed when antibiotic therapy fails, and a bilateral vasectomy is occasionally performed in men with chronic epididymitis or in elderly persons undergoing open prostate surgery .

• Epididymectomy: In an epididymectomy, the surgeon makes a small incision in the scrotum and removes the inflamed portion of the epididymis. Bed rest and ice packs and sitz baths for minor pain and swelling may help promote recovery from surgery. You should abstain from sexual intercourse until the doctor directs otherwise, and you should avoid strenuous activity or heavy lifting for a week or until the doctor advises more activity. Also, you should notify the doctor if you develop fever, persistent abdominal or scrotal pain, or bleeding at the incision.

• Vasectomy: In a vasectomy, the surgeon makes a small incision in the scrotum and ties off the vas deferens so that fluid and organisms can no longer pass to the epididymis.