Epididymitis


Last Updated December 20th, 2021

What is causing pain in the groin region?

Inflammation of the epididymis, which is a long coiled tube that stores and transports sperm from the testes is called epididymitis.  This can cause pain and swelling in the testes.  It generally affects men in the age group of 14 and 35 but can affect men of all ages.  A sexually transmitted infection or a bacterial infection can cause this problem.

There are two types of epididymitis called acute epididymitis and chronic epididymitis.  Acute epididymitis occurs suddenly and this condition can last for six weeks.  It is also associated with severe pain.  Chronic epididymitis occurs slowly over time and can last for more than six weeks.  The pain associated with this condition is comparatively milder.  A condition where the testes are inflamed is called orchitis.  When both the epididymis and the testes are inflamed together, it is called epididymo-orchitis.

Symptoms of epididymitis

Redness and swelling in the testes are not noticed until it is accompanied by pain.  Epididymitis can cause a significant amount of pain and warmth in the testes.  Pain may involve either one or both the testes.  Other symptoms may include fever, chills, enlarged testicles, testicles become sensitive to touch, pain radiating from testes to the abdomen or pelvis, burning sensation while passing urine, frequent urge to pass urine, blood in the urine, discharge from the penis, as well as fluid build-up around the testicles causing a lump.

The symptoms of epididymitis may highly depend on the cause.  If it is caused due to sexually transmitted infection, you may experience discharge from the penis.  Frequency and urgency of urination associated with burning upon urination may occur when the cause is from urinary tract infection.  Another condition called testicular torsion where the blood supply is cut off due to twisting of the testicle can also cause pain in the testes.  This is a more serious condition where surgical treatment is required.

Causes

The bacterial infection caused either by sexually transmitted infection or through urinary tract infection are the two main causes of epididymitis.  It has been found that the infection generally starts in the prostate, bladder, or the urethra.  The two main causes of epididymitis are discussed below:

Sexually transmitted infection (STI)

Unprotected sex with multiple partners is considered to be the main cause of epididymitis related to STI.  It has been estimated that a maximum number of cases of epididymitis are generally related to STI and is very rarely caused by other infections.

Urinary tract infection (UTI)

UTI accounts to a minimal number of cases causing epididymitis.  Children and older men are usually affected.  Some of the risk factors that cause UTI include enlarged prostate that can be pressing on the bladder, insertion of the catheter into the penis due to kidney problems, as well as surgery affecting the bladder, groin, or the prostate gland.  Some of the other causes of epididymitis in children include injury to the region, abnormal twisting of the epididymis, as well as urine flowing back into the epididymis.  These bacterial infections generally spread from the urethra or bladder.

Other causes of epididymitis

Several other medical conditions can cause epididymitis and these include mumps, Behcet disease, tuberculosis, medication side effects from amiodarone, anatomical problems of the urinary tract, injury to the groin, as well as congenital problems related to the kidney and the bladder.

Diagnosis

Finding the cause of the symptom would be the first thing your doctor would concentrate on.  The doctor would inquire about your medical history to understand the cause.  This will be followed by a thorough physical examination.  Next, a urine sample will be collected to look for the presence of bacteria.

When a patient is suffering from acute epididymitis, the urine is generally infected whereas during chronic epididymitis, urine is not infected.  If the infection has affected the urethra, a swab test may be conducted from the urethra.  An ultrasound imaging may be required to check for blood flow in the epididymis as well as the structure of the testes.  Further tests may be required depending on the severity of the symptom.  Once a diagnosis is made, appropriate treatment will be started.

Treatment

Treatment of acute epididymitis is started with a course of antibiotics.  The antibiotic course may include a course lasting 1-2 week.  The appropriate antibiotic is determined based on the bacteria found in the urine test.  A severe case of epididymitis may require admission to the hospital.  Symptoms of fever, vomiting, as well as severe pain together, would warrant hospital admission.

Severe pain may require a prescription of narcotics for a few days.  Tuberculosis epididymitis is considered to be a very severe case but occurs rarely.  Anti-tuberculous drugs are used to treat this condition.  A very serious case might require a surgery where the teste and the epididymis may need to be removed.

Epididymitis caused by medication side effect such as amiodarone is treated by stopping the drug altogether.  Other types of non-infectious epididymitis do not have any specific treatment.

Additional care needs to be rendered for at least 1–2 days by elevating the scrotum in a lying down position.  When the scrotum area is above the heart, it helps the blood to flow adequately to the area and reduce the symptoms of swelling and pain.  Icing the area every couple of hours can relieve the symptoms.

Extra fluids would be helpful if the epididymitis is caused due to an infection.  Anti-inflammatory drugs may be prescribed to ease the pain.  The drugs also help reduce the swelling around the testes.

Treatment for chronic epididymitis is mainly accomplished with the use of pain medications and applying heat to the area.  As discussed earlier, pain associated with chronic epididymitis is generally mild and is not as severe as acute epididymitis.

Recovery

Acute epididymitis would require at least a couple of days for the swelling and pain to subside.  Once the antibiotics kick in, the symptoms would gradually decrease.  Persistence of pain and swelling after 48 hours of initiation of treatment needs to be reported to the doctor for further assistance.  Overall discomfort may last for several weeks after the course of antibiotics is completed.

Complete bed rest with elevation of the scrotum can result in fast recovery.  Tuberculous epididymitis which is the most severe form of epididymitis and needs several months to heal with medicine.  There is a high possibility that the testes may shrink after treatment and also result in reduced sperm production.  Epididymitis caused by medication side effects gets better with the cessation of the drug.  Regular follow up with the healthcare provider is important to check for any abnormalities and recurrence.

Chronic epididymitis symptoms would reduce substantially with the use of heat and pain medications.  There is always a high chance of recurrence and may even take months to years for it to recur.  Symptoms once recur may sometimes be better or even worse than the first episode.  Certain cases of chronic epididymitis may also require surgery which is quite rare.  If surgery has been done, the recovery time would generally be around a couple of weeks.  Depending on the condition, your healthcare provider may also suggest microsurgery to block nerves on the spermatic cord.

Final thoughts

Majority of acute epididymitis cases are successfully treated using suitable antibiotics.  The prognosis is generally good and may not cause any long-term sexual or reproductive problems.  There is a high possibility that the infection may return in the future and also cause some complications but is usually rare.  Seeking treatment right away is important to prevent complications.  The complete course of antibiotics should be completed for the symptoms to cure.  Regular follow up visits are needed after the treatment.  Following these directions will help ensure that you make a complete recovery.

Facts

  • Majority of epididymitis cases occur between the age group of 20 to 39.
  • Around 50% of epididymitis cases are due to Chlamydia trachomatis or Neisseria gonorrhea.

Facts

  • More than 600,000 cases of epididymitis are reported in the United States every year.
  • It has been estimated that epididymitis accounts to 0.69% of outpatient emergency room visits.

Facts

  • Epididymitis and orchitis are both caused by the same pathogens.

Related Conditions

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Dos and Don'ts

Dos
  • Maintain healthy hygiene.
  • Seek immediate medical care at the first sign of pain in the groin area.
  • Complete the course of antibiotics.
  • Add anti-inflammatory foods to your diet.
Don'ts
  • Delay treatment.
  • Stop medications abruptly.
  • Maintain unhealthy hygiene.
  • Eat unhealthy foods.

 

 

 

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Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
Moringa drink
Moringa: This could be the most nutrient-dense food known to us! Moringa is a lush green tree brimming with over 90 essential nutrients required for a healthy mind and…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
AHBC Igm
Anti-Hepatitis B Core Antigen (AHBc) IgM Anti-hepatitis B core antigen (AHBC) IgM is an investigative procedure to detect the presence of IgM antibodies in…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…