Shlomi Albert, M.D., Inc. 11160 Warner Avenue, Suite 423 Fountain Valley, Ca 92708 Tel (714)549-3333 Fax (714)549-3334 Epididymitis
Epididymitis is an inflammation of the epididymis, an oblong structure attached to the upper part of each testis. The inflammation may be so great that the testicle itself feels greatly enlarged and hardened. However, this does not mean that the testicle is infected. While bacterial infections of the epididymis are common and the most serious of the causes of epididymitis, infections are only one of many reasons that the epididymis can become inflamed. Cause Bacterial epididymitis usually results from an infection spreading to the epididymis from other male urogenital organs, the prostate, bladder, kidney, and urethra. Epididymitis may complicate an infection or may be brought on by injury to the scrotum. Epididymitis is not contagious, not inherited, and not a sign of cancer. Some rarer types of bacteria create a different picture altogether. Tuberculosis, for instance, is a bacteria that can spread to the epididymis in unusual circumstances.
Tuberculosis epididymitis develops very slowly over days and weeks. Non-bacterial epididymitis can be the result of viruses, trauma, and unknown causes. The unknown causes are commonly referred to in medicine as idiopathic, a fancy word for 'We don't have a clue!' Non-bacterial epididymitis can be just as painful and come on very quickly. When the cause is trauma or idiopathic, many believe that these types of epididymitis are caused by a rupture, or blow-out, of the sperm ducts causing a leakage of sperm fluid into the tissue. The body tissues can be quite irritated by this leakage, hence the redness and swelling. It may be difficult to understand why the body would be so irritated by a fluid that is made in the testicle. Suffice it to say that the body makes acid in the stomach, which serves a purpose to digest food. With a perforated stomach ulcer, this acid can leak into the body cavity and cause a life-threatening illness. Epididymitis is, by itself, not life-threatening, but the point is made about pain and swelling. Symptoms Symptoms of epididymitis include:
Fever. Chills. Generalized weakness. Redness, swelling and intense pain of the scrotum and epididymis. Rapid onset of symptoms, usually less than 24 hours.
Diagnosis In most circumstances, the bacteria can be identified in the urine or prostate fluid and tests can be run to determine which antibiotic is most effective. Treatment Bacterial infections are treated with antibiotics, appropriate for the bacteria that is causing the infection. Anti-inflammatory medicines, such as Ibuprofen, Feldene, Naprosyn, Toradol or Voltaren, can be very helpful in reducing the inflammation and pain. .Do not take any medicine, not even over-the-counter preparations, without first discussing it with the doctor. Prognosis (Expectations) After pain and tenderness have subsided, a certain amount of swelling and hardness around the testicle may continue. This will disappear more quickly if you sit in hot water for 15 minutes twice a day. Be careful to avoid any injury to the infected area for two or three months after all signs of inflammation have subsided.
Go to bed and stay there, except for bowel movements, until the swelling
subsides and the fever is gone. This helps the infection to drain out and reduces the pain that will occur when the scrotum is bumped from walking or moving.
Drink plenty of fluids, but limit alcoholic beverages. Take your temperature each morning and night. Keep a record. While in bed, support the weight of the scrotum and tender testicles by
rolling a soft bath towel and placing it between the legs beneath the inflamed parts. Apply either an ice bag or heat (warm compresses, electric heating pad, hot-water bottle) to the inflamed parts. Use whichever gives the most comfort.
When you are again able to be up and around, you will be more
comfortable wearing a jock strap or two pairs of jockey shorts.
Do not engage in sexual intercourse or have an ejaculation. The flow of
sperm through the epididymis during the early phase can only cause more inflammation and damage.
Call the doctor if your temperature goes above 100 degrees Fahrenheit,
the pain is not reasonably well controlled, the symptoms don't improve in four days, or you become severely constipated.
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