Epididymis is a tube located at the back of testicles that stores and carries the sperm to the vas deferens. Swelling and inflammation of epididymis is called ‘Epididymitis’. Epididymitis is very common in men aging between 14 and 35. It can also happen in men of different age groups too. Epididymitis is broadly classified into two types:
- Acute Epididymitis that usually goes away in less than 6 weeks
- Chronic Epididymitis that lasts longer than 6 weeks.
In cases of acute epididymitis, if the testicles are also inflamed (swollen testicles), that is called ‘Epididymo-Orchitis’. Major cause of epididymitis is infection due to Gonorrhea, Chlamydia (common sexually transmitted infections) or other infection.
Symptoms of Epididymitis
Symptoms of epididymitis include:
- Pain in testicles that may radiate till the groin
- Swelling and redness of testicles
- Fever and Chills
- Pain in pelvic region (due to the radiation of pain from testicles)
- Blood in semen
- Pain during sex and ejaculation
- Penile discharge
- Frequent urination
Causes of epididymitis
The most common cause of epididymitis is infection. It can either be an STD or normal infection of testicles. Most often sexually transmitted infections caused by Chlamydia or Gonorrhea cause epididymitis. Bacterium like E.Coli, mumps virus and very rarely tuberculosis can cause epididymitis.
In some cases, swelling and inflammation of epididymis can happen due to the flow of urine. (Instead of getting out through the urethra, if the urine flows into the tubes carrying semen (out of the body), it can reach epididymis and result in inflammation). Lifting of weights in wrong way, blockage of urethra, enlarged or infected prostate gland, injury to the groin can result in such scenario.
Who are at risk of developing epididymitis?
People involving in risky and unprotected sex are at highest risk of acquiring sexually transmitted infections. If the symptoms of Gonorrhea or the symptoms of Chlamydia are ignored, the infection can get to the epididymis resulting in swelling and redness of the epididymis and/or testicles.
If the urinary tract is not well formed or is injured due to any reason (such an accident or due to insertion of a catheter during a surgery), it can result in epididymitis. People who are using a specific medicine for heart problems (amiodarone) or one who is suffering from tuberculosis are at higher risk of developing epididymitis.
STDs first infect the urethra and the infection slowly travels to the epididymis region. In case of non sexually transmitted infections, the infection can start in a different part of the body and travel to the scrotum.
Do kids develop epididymitis (pediatric epididymitis)?
Yes, kids (who haven’t reached the age of 14) can also develop epididymitis called ‘Paediatric epididymitis’. This can happen due to the blockage of urethra or Urinary Tract Infection that finds its way to the testicles or due to the torsion or twisting of the epididymis. (Testicular torsion).
Symptoms of paediatric epididymitis include:
- Discharge from the penis
- Pain or burning sensation during urination
- Scrotum becomes tender to touch
Diagnosis of epididymitis
Diagnosis of epididymitis starts with careful physical examination of the groin area and the testicles. In some cases, the groin may also have swollen. If there is any discharge from the penis, your sexologist may collect it and send it to test for sexually transmitted infections. It is better to let your sex specialist know if you have had any unprotected sexual intercourse in the recent past, so that his/her diagnosis can be more accurate.
In order to find the other causes of epididymitis, your doctor may perform other tests including:
- Rectal examination – to look for enlarged prostate
- Blood test – a Complete Blood Picture / Complete Blood Count to detect for the presence of any infection
- Urine test – to look for possible Urinary Tract Infection.
An ultrasound test will give your doctor a clearer picture of the swelling inside your scrotum.
Treatment of epididymitis
In majority of the cases, epididymitis is caused due to infection. Once your doctor knows what type is the infection, you will be put on appropriate antibiotics. Along with antibiotics, pain medication may be given depending on your ability to tolerate the pain. Also, anti-inflammatory medicines may also be prescribed.
Along with medication, symptoms of epididymitis can be managed/controlled by:
- Using icepack on testicles and in the groin area
- Wearing supporting underwear or cups for supporting the testicles
- Avoid lifting heavy weights.
If the cause of your epididymitis is a sexually transmitted infection, your doctor will advise your partner also to get tested and treated for the infection. Neglecting sexually transmitted infections in women can lead to major problems such as cancer of cervix.
If you have a swollen testicle or if you feel that something is not normal with your testicles, please see a sexologist near you immediately. Be open and tell your doctor about your active sex life and your risky behaviour too. That will help him/her diagnose your problem better and treat with right medications. Always avoid risky sex behaviour. Hold your horses and put on a condom, it won’t take longer than a minute.