What is it?
Epididymitis is an inflammation of the epididymis. The epididymis is a cord-like structure lying behind the testicle. Sperm matures and is stored in the epididymis.
How do you get it?
For men who are under 35 years of age and sexually active, epididymitis is usually acquired from the STDs chlamydia or gonorrhea. Other bacteria also cause it if there are abnormalities in the urinary tract. For sexually active men over 35 years old, other non-sexually transmitted bacteria usually cause epididymitis.
What are the symptoms?
Symptoms can include:
- One-sided swelling of the scrotum (sac) and/or tenderness, noticed most over the epididymis. Occasionally happens on both sides.
- Pain in the scrotum
- Redness and swelling of the skin lying over the epididymis
- Discharge from the urethra
- Burning with urination and 'urethral awareness'
It is important to remember that some of the symptoms of epididymitis can be caused by other non-STD conditions. Some of these conditions may require immediate, urgent treatment, and therefore it is important to seek medical attention as soon as possible.
What's the test like?
There is no single test that will tell a man he has epididymitis. To check for epididymitis, a health care provider will do a visual examination of the genital area, including feeling the scrotum. A swab from the urethra for gonorrhea may be taken, and a urine sample collected for a chlamydia test. Another urine test may also be done for other bacteria.
What is the treatment?
If the epididymitis is presumed to be due to an STD, 2 types of antibiotic pills will be given for treatment. If a non-STD type of bacteria is the cause, another type of antibiotic pill would be used. Anti-inflammatory medication is also recommended. Pain should begin to subside within 3 days after beginning treatment, but may take up to 2 weeks to completely go away.
A man with presumed STD epididymitis must have all of his sexual partner(s), in the 2 months before symptoms started, treated with antibiotics effective against chlamydia and gonorrhea, regardless of whether they show symptoms or not. He should also not have any sex for 7 days after starting treatment. A partner's treatment must also be complete before resuming sexual contact.
Hospitalization should be considered when severe pain suggests other diagnoses, if he has a fever or cannot take the oral antibiotics as prescribed.
Some men continue to feel the same symptoms after treatment. This is called chronic epididymitis and is usually treated with one more course of antibiotics and anti-inflammatory medication.
If not treated?
Potential complications of epididymitis include:
- infertility, especially if both epididymes are inflamed
- formation of an abscess
- inflammation of the testicle
How common is it?
Not very, though men under 35 are most at risk for developing epididymitis. It is not a common reason for men to come in to STD clinics in Canada. Less than 1% of men with an inflammation of the urethra caused by an STD will get epididymitis.
Prevention
Abstaining (not having sex) is the most reliable way to avoid any STD.
Since chlamydia and gonorrhea are common causes for epididymitis, the ways to help reduce the chances of epididymitis are similar to preventing chlamydia or gonorrhea. Using latex condoms before the genitals touch the partner's body until there is no longer skin contact, is the best prevention.
If you are sexually active, having regular check-ups for STDs is important. If a man is experiencing any of the symptoms mentioned in the Symptoms section (link), he should seek medical attention as soon as possible.
Links
Other sites you may find interesting include:
- Emedicine - Further information on Epididymitis. Emedicine.com provides free online medical reference textbooks for doctors, medical professionals and consumers.
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