Epididymitis is inflammation of the epididymis due to infection. The condition is typically unilateral and is one of the most common infections of the male reproductive system, especially those in the age bracket of 19 to 35 years.
Epididymitis can occur as a result of prostatitis, a UTI, tuberculosis, or STDs such as gonorrhea and chlamydia. Chlamydia trachomatis and Neisseria gonorrhoeae are the most common infectious agents that cause epididymitis in sexually active males.
Signs and Symptoms
The epididymis may become enlarged, hard, and tender, causing pain. Scrotal and groin tenderness, fever, and malaise also may occur. Groin tenderness is the result of enlarged lymph nodes in the groin. Clients may “waddle” as they walk, trying to protect the scrotal area. There may be blood in semen, a discharge from the penis, and enlarged lymph nodes in the groin area.
A swab sample from urethral discharge is used to determine the presence of bacteria. Ultrasound may be ordered, especially if the symptoms were sudden and the pain is severe. Urinalysis and urine cultures help in the diagnosis. An increased leukocyte count is common.
Antibiotic and/or antimicrobial therapy appropriate for the particular causative agent is initiated. If an STD is found to be the cause, then sexual partner(s) need treatment, also.
Wearing a scrotal support and taking analgesics may be helpful. Bed rest may be necessary in the acute phase. Scrotal elevation and cool compresses (30 minutes or less) to relieve pain and reduce swelling may be helpful.
Remind clients to take all their medications and analgesics as necessary. When clients are feeling better, encourage walking and the use of an athletic supporter.
The inflammation generally responds well to therapy, but portions of the epididymis may be scarred. Orchitis may occur as a complication to epididymitis; it causes infection of the testes and can lead to sterility. Any pain, swelling, and redness of the testes should be reported immediately to the primary care provider. Because orchitis can be the result of mumps, young males should receive the mumps vaccine.
Early treatment of UTI is the best prevention. The use of a condom during sexual intimacy is recommended, especially if the causative agent was sexually transmitted.