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Epididymitis

Epididymitis is an inflammation of the tube that joins the testicle with the vas deferens. This happens most often in men under age 35 and is usually caused by a sexually transmitted infection. If men over the age of 35 get epididymitis, it is not usually caused by an STI. Less than 1% of men with an STI will get epididymitis.

Causes

Epididymitis is caused by bacteria that travel from the urethra or the bladder to the epididymis. A man can get epididymitis from:

Men of any age who have unprotected insertive anal sex can get epididymitis from intestinal bacteria. Some other conditions that are not related to STIs, such as inguinal hernia, varicocoele (enlarged scrotal veins), cysts, testicular torsion (twisting), or testicular cancer can cause symptoms similar to epididymitis.

Symptoms

Symptoms of epididymitis can include:

  • Swelling, tenderness, pain in the sac (scrotum); usually one sided, but occasionally on both sides
  • Unusual fluid from the urethra (pee hole)
  • Burning or pain when peeing
  • Itching or tingling feeling inside the penis
  • Fever

 Sudden onset of intense pain in one testicle is a medical emergency. It is important to get medical attention as soon as possible.

Complications

Complications of epididymitis include:

  • Infertility, especially if both sides are involved
  • Abscess in the sac
  • Spread of infection to other areas of the body

Tests and Diagnosis

To check for epididymitis, your health care provider will examine the sac for swelling and tenderness. You may be asked to give a urine sample and you may have a swab from the urethra to test for chlamydia, gonorrhea or other bacteria.

Treatment

Epididymitis is treated with antibiotics that are usually taken for 10 to14 days. Anti-inflammatory medication, such as ibuprofen, may also be recommended. There should be less pain within three days after you start treatment, but it may take up to two weeks for the symptoms to completely go away. Contact your health care provider or go to a hospital if you have extreme pain or a high fever.

Some men continue to feel symptoms after treatment. This is called chronic epididymitis. Talk to your health care provider if you still have symptoms after treatment.

Treatment for Partners

Anyone you have had sex with in the past two months (60 days) needs to be tested and treated. Partners are almost always given medication whether they have symptoms or not. If you have not had sex in the past two months, your last partner should be tested.

Avoid Re-infection or Prolonging Infection

It takes time for an infection to be cleared from the body, so it is important that you do not have oral, vaginal (frontal) and anal sex for seven days after you and your partners start the antibiotic treatment. If you or your partners do not finish the treatment or miss pills, the infection may be passed back to you or your partners and may cause health problems later on. If that happens, talk with your health care provider to see if you or your partners need more treatment. 

Resources

HealthLink BC – Epididymitis
 

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