Everything You Should Know About Epididymitis

Epididymitis is a common condition that affects hundreds of thousands of American men each year.

It’s characterized by painful, uncomfortable urinary symptoms and can lead to severe long-term complications if left untreated.

What is Epididymitis?

Epididymitis is a common condition that develops around the scrotum. It occurs when a tube at the back of the testicles — called the epididymis — becomes inflamed and swollen.

This tube plays an important role in the male reproductive system because it stores and carries sperm.

When issues like epididymitis develop, it can cause irreversible damage to the tube and may lead to complications like chronic pain and infertility.

What are the symptoms of epididymitis

The symptoms of epididymitis can vary depending on the severity and cause of the condition. However, you can look out for the following common signs:

• Gradual onset of scrotal pain and swelling on one side of the scrotum
• Redness and warmth in the scrotal area
• Urinary symptoms
• Fever and chills
• Pain during ejaculation or bowel movements
• Enlarged lymph nodes in the groin

If you experience any of these symptoms — especially if they persist or worsen — it’s essential to seek medical attention as soon as possible.

What are the Causes of Epididymitis?

There are various factors that can cause epididymitis to develop. Let’s take a closer look at what they are.

Bacterial infections

The majority of cases of epididymitis are the result of bacterial infection. This type of epididymitis usually develops as a result of:

• A sexually transmitted infection (STI)
• A urinary tract infection (UTI)
• Prostate issues, including bacterial prostatitis (infection of the prostate gland)

Epididymitis caused by STIs is more prevalent in younger, sexually active males, while UTIs and prostate conditions are the more common causes among older men.

Chemical epididymitis

Chemical epididymitis occurs when urine flows back into the epididymis tube. The chemical composition of urine irritates the lining of the tube, leading to inflammation and swelling.

This form of epididymitis can happen due to heavy lifting, straining, or other activities that increase lower abdominal pressure.

Trauma

Physical trauma to the scrotum or groin — including injury during sports or issues arising from a pelvic surgical procedure — can result in swelling and inflammation of the epididymis.

This can lead to the development of epididymitis.

Other causes

Other, less common factors that can lead to the development of epididymitis may include:

• Tuberculosis (TB): In rare instances, TB can cause epididymitis — particularly in areas where this disease is prevalent. Epididymis usually develops as a secondary complication of genitourinary TB, a type of tuberculosis that affects the genital tracts.

• Medical procedures: Procedures like prostate surgery or urinary catheterization can sometimes lead to epididymitis if proper care isn’t taken after the surgery.

• Medications: Certain medications — especially those used for heart conditions — can cause epididymitis as a side effect.

• Structural abnormalities: Men with structural abnormalities in their urinary tract are at a higher risk of developing UTIs, which can increase the risk of epididymitis.

• Chronic conditions: Conditions like an enlarged prostate or regular use of a urinary catheter can also be contributing factors.

How is Epididymitis Diagnosed?

Diagnosing epididymitis involves assessing your medical history, undergoing a physical examination, and having various tests done.

Your doctor will perform all of these steps to determine the severity of your epididymitis and identify the underlying cause responsible for it.

When assessing your medical history, your doctor will ask you about:

• Any symptoms you’re experiencing
• Your sexual history
• History of STIs or similar conditions
• Recent injuries or medical procedures
• Urinary symptoms and past UTIs

After the medical history check has been completed, your doctor will conduct a physical exam.

During this exam, your doctor will inspect the scrotum, testicles, and epididymis to identify any signs of swelling, tenderness, or redness.

They will also check for enlarged lymph nodes and perform a rectal exam if you’re older than 35 or at risk of developing an enlarged prostate.

Depending on the results of the physical examination, your doctor may recommend a number of tests to determine your diagnosis. These may include:

• A urine test
• Blood work
• An ultrasound
• STI screening

In rare cases, your doctor may request additional screenings, like MRI and CT scans or a tuberculosis test, to explore other potential causes of epididymitis.

Once your test results are available, your doctor will inform you of your diagnosis and recommend appropriate next steps.

What are the Epididymitis Treatment Options?

There are various treatment options for epididymitis, depending on the underlying cause and severity of your condition:

Antibiotics

Epididymitis is usually treated with antibiotics if it’s caused by a bacterial infection, such as STI like chlamydia or gonorrhea.

Antibiotics are typically prescribed for 10 to 14 days, but the duration can vary depending on the severity of the infection and how you respond to the medication.

If your doctor has prescribed antibiotics, it’s important to complete the entire course, even if your symptoms improve.

This helps to prevent the development of antibiotic resistance which can make it more challenging to treat infections in the future.

Pain management

There are some steps you can take to reduce pain and swelling associated with epididymitis. These may include:

• Getting enough bed rest
• Elevating the scrotum
• Applying cold packs to the scrotum for short periods

You can also take over the counter (OTC) pain relievers — like ibuprofen — to help relieve discomfort and reduce inflammation.

Lifestyle adjustments

Depending on the cause of your epididymitis, your doctor may recommend making a few lifestyle adjustments to alleviate discomfort. This can include:

• Wearing an athletic supporter or snug-fitting underwear to support the scrotum
• Avoiding sexual activities until your condition is resolved
• Staying hydrated
• Making dietary adjustments to avoid foods that irritate the bladder

These lifestyle changes can also help you prevent future infections and complications, especially if used alongside medications.

Surgical intervention

In rare cases, your doctor may suggest surgical procedures to treat your epididymitis if it’s caused by an infection. Surgical intervention is typically only recommended when:

• An abscess develops and needs to be drained
• The infection causes significant tissue damage, and partial removal of the epididymis must be considered

Your doctor will typically determine the need for surgical intervention during follow-up appointments.

During these check-ups, they will assess how effective your current treatment methods are and recommend adjustments if necessary.

If your current treatments aren’t working, your doctor may recommend surgical intervention.

Can Epididymitis Cause Any Complications?

While epididymitis is highly treatable, it can cause complications if proactive steps aren’t taken to overcome your infection. Potential complications may include:

• Chronic epididymitis: This occurs when symptoms persist for six weeks or more despite treatment. Chronic epididymitis can lead to ongoing discomfort and pain in the scrotum and groin area.

• Epididymo-orchitis: If an infection spreads from the epididymis to the testicle, it can cause epididymo-orchitis — inflammation of both the epididymis and the testicle — leading to acute scrotal pain and swelling.

• Issues with fertility: In rare cases, prolonged inflammation or repeated episodes of epididymitis can affect sperm function and transport, potentially resulting in fertility issues.

• Testicular atrophy: Severe or chronic epididymitis can lead to shrinkage (atrophy) of the affected testicle, which might impact its function.

• Fournier's gangrene: In rare and severe cases, an infection can spread from the epididymis to the surrounding tissues and cause Fournier's gangrene, a life-threatening disease that requires emergency medical treatment.

Can You Prevent Epididymitis?

While not all cases of epididymitis can be prevented, there are measures that you can put in place to significantly reduce your risk of developing this condition. These may include:

• Practicing safe sex by using barrier methods, like condoms
• Maintaining good genital hygiene
• Getting regular check-ups and screenings
• Avoiding known bladder irritants, like caffeine, alcohol, and spicy foods

Depending on your specific lifestyle, your doctor may also recommend more specific preventative strategies for epididymitis.

It’s recommended to schedule an appointment with them if you have any questions or concerns about your risk of infection.

Should You See a Doctor About Epididymitis?

If you suspect you might have epididymitis, it's crucial to see a doctor as soon as possible.

This condition — characterized by pain, swelling, or redness in the scrotum — requires immediate medical attention to avoid complications.

You should also consult your doctor if your epididymitis infection is sexually transmitted. Avoiding seeking medical care can lead to prolonged discomfort and potentially serious health consequences.

Remember, prioritizing your health and addressing symptoms early is key to a quick and full recovery from epididymitis.

Where Can You Learn More About Epididymitis and Similar Conditions?

If you’re concerned about your symptoms or want to know more about treating epididymitis, LifeMD is here to help.

LifeMD can connect you to a team of medical professionals who can assist you with information and provide guidance on managing epididymitis while avoiding further complications — all from the comfort of your home.

Make an appointment today to get started.