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.

 

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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Support and care tips for helping people with depression Read to find out what is depression, its causes and symptoms. Also check out the steps describing how…
Blood Disorders cancer
Immunotherapy immunotherapy is a treatment that boosts the body's immune system to identify the cancer cells and fight cancer.
Lung cancer xray
Lobectomy Lobectomy is a surgery where a lobe of the diseased lung is removed. It is mainly done to…
heartfail_2
Open Heart Surgery An open heart surgery is a major procedure performed to treat heart diseases like congenital heart problem, heart…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
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…
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
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…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
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…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Alp enzyme-test
ALP test – Alkaline Phosphate ALP or alkaline phosphate is an enzyme mainly produced by the liver and gallbladder. ALP test measures the…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
edamame
Edamame: How healthy are these green baby beans? Edamame or "immature" soybeans are soft and easily digestable forms of soybeans that are great as an eveyday…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…

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