By Laura Rollán Guilén BSc (embryologist).
Last Update: 12/23/2014

Epididymitis is the inflammation of the epididymis, the tubular structure that connects the testicle with the vasa deferentia and where spermatozoa mature. It causes acute pain and swelling, and it is usually very annoying for men. Furthermore, during its whole duration, men lose sexual potency.

Symptoms of epididymitis

The symptoms can be slight fever, swelling, unilateral pain in the genitals, and feeling the testicle heavy. It’s common that these men have a sensation of warmth in the testicles, or that they feel that one is heavier than the other. Other symptoms that can be related with the inflammation are pain, discomfort when urinating, and, in more severe cases, blood in sperm.

The pain in the testicles must always be taken seriously and the doctor must be immediately consulted, especially if, after a hit, a stabbing pain is felt, even though two or three days have gone by. There is a more severe alteration named testicular torsion, in which the blood flow doesn’t get to one of the testicles. This alteration must be examined as soon as possible by an expert, and it sometimes requires an urgent intervention to be corrected.

Male reproductive anatomy

Causes of epididymitis

It’s more common in sexually active men between 19 and 35 years. It’s due to the dissemination of one bacterium from the tissues next to the epididymis, such as the urethra, prostate and bladder.

It’s common in heterosexual young men. It tends to be sexually transmitted and caused by bacteria, such as Neisseria gonorrhoea (thas causes gonorrhoea), and Chlamydia trachomatis (that produces chlamydia).

In children, men older than 35, and homosexual people, the infection is caused by bacteria, such as Escherichia coli. Other bacteria that can provoke the inflammation are: Mycobacterium tuberculosis or Ureaplasma urealyticum.

Another cause is the consumption of a medication named amiodarone, which prevents the abnormal heart rythms and genitourinary malformations (younger than 2 years).

Factors that increase the risk of epididymitis

  • Not being circumcised.
  • Recent surgery in the urinary tract.
  • Regular use of urethral catheter.
  • Sexual relationships without protection with more than one partner.

Treatment

Antibiotic treatment is prescribed to stop the infection. In the cases in which it has been sexually transmitted, specific antibiotics are used for the bacteria that cause it and sexual partners must also be treated. Painkillers or anti-inflammatory medication may be needed to relieve pain and swelling. If it was provoked by amiodarone, the treatment will consist on administrating a lower dose or on changing the medication.

Epididymitis caused by bacteria is treated with antibiotics

Furthermore, the pain is relieved by resting in bed and raising the scrotum and by the application of ice on the infected area. It’s recommended to visit the doctor after the treatment, to verify that the patient has got over the infection.

In the case that no treatment is prescribed, the epididymitis can become chronic. In this case, there’s no inflammation but it’s painful. If there are complications, epididymitis can provoke infertility. That’s why it’s important to consult the doctor as soon as possible, to treat the infection and avoid complications.

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Authors and contributors

 Laura Rollán Guilén
Bachelor's Degree in Biology from the University of Valencia (UV). Specialist in Human Assisted Reproduction. Writer of scientific contents. More information