Epididymitis


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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Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
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…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
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…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
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…
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…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
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…
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?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…