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The epididymitis is a finger-shaped structure that lies behind the testicle, one on each side.  Epididymitis is inflammation or infection of the coiled tube that collects sperm from the testicle and passes it on to the vas deferens, which is called the epididymis.

Epididymitis is most common in men between the ages of 14 and 35 years, with a second peak in men over the age of 60.  and is usually caused by a bacterial infection or by a Sexually Transmitted Infection (STI). In older men, it is often caused by bacteria, especially with partial bladder obstruction caused by an enlarged prostate, partial blockage of the urethra, urethral instrumentation (such as a catheter), and bacterial prostatitis (infection of the prostate gland).

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Diagnosing Epididymitis

Your urologist will run a series of diagnostic tests if you are experiencing symptoms of epididymitis. Tests can include:

  • Physical exam to include the prostate
  • Urinanalysis or a urine culture to test for a bacterial infection
  • Screening for sexually transmitted diseases
  • Ultrasound imaging of the scrotum to visualize the epididymis if your doctor is concerned about another condition called testicular torsion, or twisting of the spermatic cord, which also presents with sudden pain in the scrotum. This is more common in boys and younger men but can occur at any age.

Symptoms of Epididymitis

Symptoms of acute epididymitis (sudden onset) can include:

  • Testicular pain
  • Swollen or tender scrotum that may be accompanied by redness or warmth of the skin
  • Urethral pain
  • Urinary urgency or frequency
  • Painful/burning sensation when urinating
  • Fever
  • Flank or abdominal pain or discomfort

In chronic epididymitis, symptoms typically develop over a day or two and get better with treatment, although recurrence is possible. Symptoms are less severe than in acute or sudden onset epididymitis and usually include mild discomfort and localized pain in the scrotum. Typically, urinary symptoms are not associated with chronic epididymitis.

Treatment for Epididymitis

For acute epididymitis caused by a bacterial infection or sexually transmitted disease, your urologist will prescribe oral antibiotics to clear up the infection. Your doctor may want to schedule a follow-up appointment to ensure the infection has cleared up entirely.

Other therapies that may prove effective for minimizing pain and discomfort, especially in chronic epididymitis include:

  • Bed rest for one to two days
  • Elevation of the scrotum to help improve blood flow, which promotes healing (lying in bed, place a rolled up towel under your scrotum to elevate)
  • Non-steroidal anti-inflammatory medications can help with pain associated with chronic epididymitis