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Introduction The epididymis is a reproductive organ located at the back of the testis and connected to the vas deferens
.
The epididymis can store and carry sperm
.
After the sperm leaves the testis, it continues to grow and develop in the epididymis
.
Epididymitis refers to inflammation of the epididymis, which often occurs in young and middle-aged men (Figure 1)
.
Epididymitis is most often caused by bacterial infections, including sexually transmitted infections such as gonorrhea or chlamydia
.
Sometimes, the testicles also become inflamed, a condition called epididymo-orchitis
.
Figure 1 Epididymitis (normal on the left, epididymitis on the right) etiology The causes of epididymitis include the following: ➤ Sexually transmitted infections
.
Gonorrhea and chlamydia are the most common causes of epididymitis in sexually active young men
.
➤ Other infections
.
Bacteria from urinary tract or prostate infections can spread from the infection site to the epididymis
.
In addition, viral infections, such as mumps virus, can also cause epididymitis
.
➤Chemical epididymitis
.
This occurs when urine flows back into the epididymis, possibly caused by heavy lifting or straining
.
➤ Trauma
.
Injuries to the groin can cause epididymitis
.
➤ Tuberculosis
.
Epididymitis caused by tuberculosis is less common
.
Symptoms Symptoms and signs of epididymitis include the following: ➤ Scrotal swelling, redness, or warmth ➤ Testicular pain and tenderness, usually gradually on one side ➤ Painful or urgent or frequent urination ➤ Penile discharge ➤ Lower abdominal or pelvic pain or discomfort ➤ blood in semen ➤ fever, an uncommon complication Complications of epididymitis include: ➤ scrotum filled with pus (abscess) ➤ epididymo-orchitis, when the infection spreads from the epididymis to the testes ➤ decreased fertility, less common Chronic epididymitis that persists for more than 6 weeks or recurs is called chronic epididymitis, and symptoms may appear gradually
.
Sometimes the cause of chronic epididymitis cannot be determined
.
Diagnostic analysis involves examining the patient for enlarged lymph nodes in the groin area and enlarged testis on the affected side, as well as for prostate enlargement or tenderness by digital rectal examination
.
Suggested tests also include: ➤ Screening for sexually transmitted infections
.
A male swab is inserted into the end of the penis to obtain a sample of urethral secretions
.
Test specimens in the laboratory for gonorrhea and chlamydia
.
➤ Urine and blood tests
.
Analyze urine and blood samples for abnormalities
.
➤ Ultrasound
.
This imaging test can be used to rule out testicular torsion
.
Color Doppler ultrasound can determine whether blood flow to the testicles is lower than normal (indicating torsion) or higher than normal, which will help confirm epididymitis
.
Antibiotics are required to treat bacterial epididymitis and epididymo-orchitis
.
If the cause of the bacterial infection is a sexually transmitted infection, the patient's sexual partner also needs treatment
.
Patients will feel better within 48 to 72 hours after taking antibiotics
.
Even if the patient's symptoms resolve quickly, antibiotics should be given for a full course of treatment to ensure complete resolution of the infection
.
Taking breaks, using exercise bands, ice packs, and pain relievers can all help relieve discomfort
.
Patients are advised to follow up regularly to check whether the infection has cleared
.
Surgery If an abscess has formed, surgery may be needed to drain the abscess
.
Sometimes, surgery to remove all or part of the epididymis (epididymectomy) is required
.
Surgery may also be considered if epididymitis is caused by an underlying physiological abnormality
.
Life>
.
To relieve discomfort, the patient is advised to: ➤ Bed rest ➤ Lie down with the scrotum elevated ➤ If tolerated, use an ice pack to cool the scrotum ➤ Wear sports braces ➤ Avoid heavy lifting ➤ Avoid sexual intercourse until infection clears
.
The epididymis can store and carry sperm
.
After the sperm leaves the testis, it continues to grow and develop in the epididymis
.
Epididymitis refers to inflammation of the epididymis, which often occurs in young and middle-aged men (Figure 1)
.
Epididymitis is most often caused by bacterial infections, including sexually transmitted infections such as gonorrhea or chlamydia
.
Sometimes, the testicles also become inflamed, a condition called epididymo-orchitis
.
Figure 1 Epididymitis (normal on the left, epididymitis on the right) etiology The causes of epididymitis include the following: ➤ Sexually transmitted infections
.
Gonorrhea and chlamydia are the most common causes of epididymitis in sexually active young men
.
➤ Other infections
.
Bacteria from urinary tract or prostate infections can spread from the infection site to the epididymis
.
In addition, viral infections, such as mumps virus, can also cause epididymitis
.
➤Chemical epididymitis
.
This occurs when urine flows back into the epididymis, possibly caused by heavy lifting or straining
.
➤ Trauma
.
Injuries to the groin can cause epididymitis
.
➤ Tuberculosis
.
Epididymitis caused by tuberculosis is less common
.
Symptoms Symptoms and signs of epididymitis include the following: ➤ Scrotal swelling, redness, or warmth ➤ Testicular pain and tenderness, usually gradually on one side ➤ Painful or urgent or frequent urination ➤ Penile discharge ➤ Lower abdominal or pelvic pain or discomfort ➤ blood in semen ➤ fever, an uncommon complication Complications of epididymitis include: ➤ scrotum filled with pus (abscess) ➤ epididymo-orchitis, when the infection spreads from the epididymis to the testes ➤ decreased fertility, less common Chronic epididymitis that persists for more than 6 weeks or recurs is called chronic epididymitis, and symptoms may appear gradually
.
Sometimes the cause of chronic epididymitis cannot be determined
.
Diagnostic analysis involves examining the patient for enlarged lymph nodes in the groin area and enlarged testis on the affected side, as well as for prostate enlargement or tenderness by digital rectal examination
.
Suggested tests also include: ➤ Screening for sexually transmitted infections
.
A male swab is inserted into the end of the penis to obtain a sample of urethral secretions
.
Test specimens in the laboratory for gonorrhea and chlamydia
.
➤ Urine and blood tests
.
Analyze urine and blood samples for abnormalities
.
➤ Ultrasound
.
This imaging test can be used to rule out testicular torsion
.
Color Doppler ultrasound can determine whether blood flow to the testicles is lower than normal (indicating torsion) or higher than normal, which will help confirm epididymitis
.
Antibiotics are required to treat bacterial epididymitis and epididymo-orchitis
.
If the cause of the bacterial infection is a sexually transmitted infection, the patient's sexual partner also needs treatment
.
Patients will feel better within 48 to 72 hours after taking antibiotics
.
Even if the patient's symptoms resolve quickly, antibiotics should be given for a full course of treatment to ensure complete resolution of the infection
.
Taking breaks, using exercise bands, ice packs, and pain relievers can all help relieve discomfort
.
Patients are advised to follow up regularly to check whether the infection has cleared
.
Surgery If an abscess has formed, surgery may be needed to drain the abscess
.
Sometimes, surgery to remove all or part of the epididymis (epididymectomy) is required
.
Surgery may also be considered if epididymitis is caused by an underlying physiological abnormality
.
Life>
.
To relieve discomfort, the patient is advised to: ➤ Bed rest ➤ Lie down with the scrotum elevated ➤ If tolerated, use an ice pack to cool the scrotum ➤ Wear sports braces ➤ Avoid heavy lifting ➤ Avoid sexual intercourse until infection clears