Epididymitis

What is epididymitis?

Epididymitis is an infection or, more often, an inflammation of the epididymis (tissue that covers the testicle from the top and back like a hood). In the majority of cases, the disease is the result of a bacterial infection. Although men of any age can develop testicular inflammation, it most often occurs between the ages of 20 and 39.

When it develops in children, the inflammation is usually due to trauma. However, some children may develop a bacterial infection of the epididymis as a result of sexual abuse. In most people, the disease manifests itself as pain and discomfort in the area of ​​the testicles or groin, and in rare cases, those affected develop a high fever, unusual discharge from the penis or blood in the urine.

What are the symptoms?

The manifestations of the inflammation begin gradually and are most often fully manifested after about 24 hours. The pain is usually felt in the scrotum and groin.

• Abdominal or groin pain – initially the inflammation starts in the vas deferens – the tube through which sperm reach the urethra, and then involves the epididymis. This ‘lowering’ of inflammation explains why symptoms may initially appear in the groin – the lower back and groin. One testicle may be more painful than the other.
• Scrotal pain and swelling of the epididymis which may swell up to 2 times its normal size within 3-4 hours. The degree of swelling is often variable.
• Pain on urination and sometimes blood in the urine.
• Discharge from the urethra, especially in men under 39 years of age.
• High fever, chills and nausea;

What are the causes?

The cause is usually a bacterial infection. The bacteria usually cause infections in the urethra, the prostate and through the vas deferens reach the epididymis. A bacterial causative agent is identified in about 80% of cases.

There are two groups of infectious organisms that cause inflammation of the epididymis. These are the organisms that cause sexually transmitted diseases and coliforms – organisms that inhabit the intestines.

In men under the age of 39, in about 50-60% of cases, the causative agents are the bacterial species causing gonorrhea and chlamydia.

In older adults over the age of 39, the causative agents are usually coliforms, most commonly the bacterium Escherichia coli.

These organisms also often cause bladder infections. At any age, people who have anal sex are at risk of exposure to the bacteria Escherichia coli or other fecal bacteria. The disease can very rarely be caused by fungi or Mycobacterium SPP.

In even rarer cases, inflammation of the epididymis may be due to backflow of urine due to sex or sports with a full bladder. The drug amiodarone, which is used for cardiovascular diseases, sometimes causes inflammation of the epididymis.

Treatment of epididymitis

Most often, antibiotic therapy is applied, as at the discretion of the doctor, they can be infused intravenously, injected or taken orally, in the latter case, the treatment should last longer of 10 days.

Often, the therapy that will be administered depends on what bacteria are causing the infection. And in most cases, doctors choose combination therapy with at least two different antibiotics, because sometimes the infectious organisms are of several varieties.

For men under 39:

• Ceftriaxin – single dose intramuscularly or intravenously and one dose of azithromycin.
• Doxycycline tablets 2 times a day for 10 days in addition to the single dose of ceftriaxin.
• Ceftriaxone 250 intramuscularly plus doxycycline 100 mg is most often prescribed. orally twice a day for 10 days.

For men over 39 or those who practice oral sex:

• Ciprofloxacin tablets twice a day for 10-14 days.

Sulfamethoxazole and trimethoprim tablets twice also 10-14 day intake.