Epididymitis is a condition characterized by inflammation of the epididymis which is located posterior to the testicles, responsible for storing and carrying sperm. Such a kind of condition can strike males at any age.
Epididymitis presents with the following signs and symptoms:
- The scrotum becomes swollen, red and is warm to touch
- Development of pain in the testicles along with tenderness
- Urination becomes painful with an increased urge to urinate frequently
- Painful ejaculation and intercourse
- Presence of blood in semen
- Pain in the lower abdominal region
- Development of lump on testicles
- Discharge occurs from penis
Entire Body System
Symptoms The main symptoms are fever and pain, developing progressively over several hours, in the back portion of the testicles. Symptoms include fever and chills, pain in the groin, and tender, swollen epididymes. [healthcentral.com]
In addition, individuals would also experience painful urination, discharge from penis, painful intercourse, blood in semen and fever. [symptoma.com]
It may be associated with irritative lower urinary tract symptoms, urethral discharge, and fever. It is usually unilateral. The condition is referred to as acute epididymo-orchitis if concurrent inflammation of the testis is present. [bestpractice.bmj.com]
In bacterial epididymitis, patients may also have fever, nausea, or urinary symptoms. Urethral discharge may be present if the cause is urethritis. [msdmanuals.com]
- Low Fever
fever Chills Feeling of heaviness in the testicle area The testicle area will get more sensitive to pressure. [mountsinai.org]
Symptoms Epididymitis may begin with: Low fever Chills Feeling of heaviness in the testicle area The testicle area will get more sensitive to pressure. It will become painful as the condition progresses. [account.allinahealth.org]
fever and chills The specific symptoms depend on the cause of the condition. [news-medical.net]
Mardh in Sweden who found some increased incidence of epidydimitis in men undergoing rigorous prostatic massage in the presence of undiagnosed chlamydial infection. [prostatitis.org]
It would be helpful to calculate the etiology and pathogenesis of this condition by applying the same scientific rigor that is presently being employed in the evaluation of the etiology and pathogenesis of prostatitis and interstitial cystitis. [ncbi.nlm.nih.gov]
[…] pain or pain associated with rheumatic diseases is not strong for any benefit and further research is needed. For chronic non-cancer pain, a recent study concluded that it is unlikely that cannabinoids are highly effective. However, ore rigorous [en.wikipedia.org]
- Inguinal Pain
The physician needs to be aware that an embarrassed child may state that he has lower abdominal or inguinal pain rather than scrotal pain. A child may also minimize his symptoms out of fear. [aafp.org]
Veterinarians, in a breeding soundness examination of a ram, will measure the scrotal circumference at the widest point. In a chronic epididymitis case this will be less than expected for that ram’s body weight, age and season of the year. [omafra.gov.on.ca]
- Skin Lesion
DDEB, pruriginosa (DDEB-pr) DDEB pruriginosa is a rare subtype of DEB characterized by generalized or localized skin lesions associated with severe, if not intractable, pruritus. [debra.org]
Shaft of penis with papules, nodules, ulcers or other skin lesions. Palpation Of inguinal region for tender lymphnodes. Of spermatic cords to rule out tenderness, asymmetry, and thickening. [speciality.medicaldialogues.in]
Areas of skin atrophy and scarring were noted on the periphery of the lesions. [dovepress.com]
- Skin Ulcer
10/1/2016) : No change 2018 (effective 10/1/2017) : No change 2019 (effective 10/1/2018) : No change Didymytis N45.1 Epididymitis (acute) (nonvenereal) (recurrent) (residual) N45.1 Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin [icd10data.com]
Skin ulcer over the swelling C. Dermal Edema D. Satellite Nodule13. Which of the following is not an etiological factor for pancreatitis? A. Abdominal trauma B. Hyperlipidemia C. Islet cell hyperplasia D. [ukmall.net]
- Foreign Body Sensation
Symptoms of Entropion Even one eyelash poking into your eye causes a foreign body sensation. A whole row of ingrown eyelashes causes severe and chronic discomfort. [theeyepractice.com.au]
The eye may tear and a foreign body sensation or irritation is often felt. [eyelidsphoenix.com]
Both entropion and ectropion can irritate the eyes, causing a feeling that something is in the eye (foreign body sensation), watering, and redness. [msdmanuals.com]
Causes of Entropion relaxation of eyelid tissue due to aging changes chronic infections with scarring on the inner surface of the eyelid traumatic eyelid injuries tumors Symptoms of Entropion excessive tearing foreign body sensation sensitivity to light [eyeassociatesoftallahassee.com]
There may be a foreign body sensation in the eye, or excessive tearing, crusting of the eyelid, or discharge. Irritation of the cornea may develop from lashes rubbing on the eye. [asoprs.org]
- Visual Impairment
"Global data on visual impairment in the year 2002" (PDF). Bull World Health Organ. 82 (11): 844–851. doi:10.1590/S0042-96862004001100009 (inactive 2020-02-26). PMC 2623053. PMID 15640920. [en.wikipedia.org]
This reflex by the superior and medial aspect of the thigh being lightly stroked in any direction, the normal response should be the pulling of the testis ipsilaterally by the contraction of the cremaster muscle. [kenhub.com]
Feet Carpal Tunnel Syndrome Diet and Nutrition Emergency Supplies Fall Prevention Fibromyalgia Fitness and Health Hearing Loss Home Health Care and Safety Industrial and Public Health Safety Occupational Health Safety Sight Impaired Sleeping - COPD Stroke [activeforever.com]
Critical Care Our emergency medicine physicians and nurses who are dedicated to the care of patients with broken arms and “broken” hearts to stroke or sudden pain and more. [excelahealth.org]
The cremasteric reflex (elevation of the testicle in response to stroking the upper inner thigh) remains normal. This is a useful sign to distinguish it from testicular torsion. [en.wikipedia.org]
To differentiate epididymitis from testicular torsion, the doctor may test the cremasteric reflex (in which the testicle rises when the inner thigh is stroked). A positive cremasteric reflex generally excludes testicular torsion as a cause. [verywellhealth.com]
- Testicular Pain
Chronic epididymitis refers to inflammation characterized by persistent testicular pain in the absence of scrotal swelling. This condition is usually more difficult to treat and may result in long-term pain. [innerbody.com]
Epididymitis usually begins with a gradual onset of testicular pain that increases in severity over time. The testicle can become swollen, tender to touch and red. [chop.edu]
pain and often unilateral lower abdominal pain urinary frequency or urgency urinary dysuria Physical exam fever testicular erythema, tenderness, and induration cremasteric reflex intact Prehn's sign decrease in pain with scrotal elevation Imaging Ultrasound [medbullets.com]
- Swelling of the Scrotum
Diagnosis and Treatment In acute epididymitis, the physical examination shows tenderness and swelling of the scrotum, discharge from the penis, enlarged groin lymph nodes, and fever. [innerbody.com]
A 19-year-old adolescent, presented to urologist with painful swelling of the scrotum on the left side over the preceding several days. Antibiotics were administered by physician for two months and the pain improved, but the swelling did not fade. [ncbi.nlm.nih.gov]
Appears pain and swelling in the scrotum by the defeat, increased epididymis several times, redness of the skin of the scrotum men impotency. Often combined with inflammation of the testicle (orchiepididymitis). [carbohealth.com]
Pain, tenderness, and swelling in the scrotum (epididymides or testicles) that gradually get worse are the most common symptoms of epididymitis. [healthlinkbc.ca]
Symptoms Symptoms of epididymitis and orchitis can include: Pain, swelling and tenderness in your scrotum. Only one side of the scrotum is affected. Pain that at first is most intense at the back of one testicle. [2minutemedicine.com]
- Enlargement of the Prostate
And in older men it is often caused by enlargement of the prostate gland. Bacterial infections, possibly spread from the rectal area or following a urological procedure, also may cause epididymitis. And an injury to the groin may cause epididymitis. [healthlinkbc.ca]
- Testicular Swelling
swelling and tenderness; normal cremasteric reflex; pain relief with testicular elevation (Prehn sign) Enlarged, thickened epididymis with increased blood flow on color Doppler Orchitis Abrupt onset of testicular pain Testicular swelling and tenderness [aafp.org]
Scrotal pathologic changes in general and testicular swellings particularly offer an open challenge to the medical profession. [jamanetwork.com]
Age at presentation and likelihood of testicular swelling or hydrocele was not different between children with and without UTAs. [ncbi.nlm.nih.gov]
Patients would not likely see as much testicular inflammation with a type of UTI. It is essential to see your physician immediately if you have any symptoms of pain during urination or testicular swelling. [msurology.com]
- Painful Ejaculation
ejaculation and intercourse Presence of blood in semen Pain in the lower abdominal region Development of lump on testicles Discharge occurs from penis Some males with epididymitis may also suffer from low grade fever accompanied by chills. [symptoma.com]
You may also have: tenderness in the scrotum painful urination painful ejaculation a swollen scrotum blood in the semen abnormal discharge an enlarged prostate swollen lymph nodes in the groin a fever A virus or bacteria can cause orchitis. [healthline.com]
Symptoms of orchitis The symptoms of orchitis include: Blood in the semen, a clear or yellow discharge from penis, fever, g roin pain, painful ejaculation, Pain with intercourse or ejaculation, pain with urination, scrotal swelling, tender, swollen groin [neilbaum.wordpress.com]
ejaculation The appearance of a lump on the testicle Enlargement of the lymph nodes in the groin Pain or discomfort in the lower abdominal or pelvic area Fever or chills 5 Vomiting 3 If these symptoms constantly reoccur or continue to affect the individual [soc.ucsb.edu]
A preliminary physical examination is carried out to diagnose signs and symptoms of the disease. It would reveal enlarged lymph nodes and testicles. A rectal examination may also follow to study for prostate enlargement or any accompanying tenderness. In addition to physical examination, the following tests would also be done to confirm the condition.
- Screening for sexually transmitted infections: Swabs from urethra is collected to analyze it for the presence of gonorrhea or chlamydia.
- Urine and blood samples are checked for abnormalities.
- Ultrasound examination is done to rule out testicular torsion. This method is used along with color Doppler examination to evaluate the blood flow to the testicles. If the blood flow is lower than normal then it indicates testicular torsion. If the blood flow is higher than normal, then the diagnosis of epididymitis stands confirmed  .
There are two main infectious causes: (1) urethral infection with Neisseria gonorrhoeae or Chlamydia trachomatis, and (2) genitourinary tract infection with coliform bacteria or Pseudomonas aeruginosa (see Table 6–1 ). [accessmedicine.mhmedical.com]
Infections with urinary coliforms (eg, E coli, Pseudomonas species, Proteus species, Klebsiella species) are the most common cause in children and in men older than 35 years. [emedicine.com]
Therefore, the most common pathogens are E. coli, Proteus spp., Klebsiella pneumoniae, and Pseudomonas aeruginosa. [teachmesurgery.com]
E. coli or Pseudomonas bacteria usually cause the infection, as a result of: Enlarged prostate gland pressing on the bladder Insertion of catheter into the urinary system Surgery to the prostate gland, bladder or groin region Surgery or Trauma to the [news-medical.net]
Since epididymitis occurs due to bacterial infection, antibiotics form the most effective treatment regime. In case the condition is caused due to sexually transmitted infections, then the partner would also require treatment through antibiotics.
Tenderness in the scrotum may take several weeks to correct and therefore, certain other methods such as application of ice packs, resting, medications can help. In addition, males are also advised to tie an athletic strap around the scrotum to relieve the tenderness.
Surgery is required when there is formation of abscess. In many cases, parts of the epididymitis may be required to be surgically removed. Such a kind of method is known as epididymectomy .
The prognosis of the condition is favorable with pain resolving within 1 to 3 days. However, the induration can take several months to get corrected. If treatment is not initiated on time, it can further lead to development of epididymal abscess. This can in turn lead to development of infertility amongst the affected population. Individuals who have developed the condition due to sexually transmitted infections should receive prompt treatment as they are at an increased risk of developing HIV infection .
Bacterial infections like gonorrhea and chlamydia are known to cause epididymitis amongst the sexually active male population. Bacterial infections of the prostrate or urinary tract can extend up to the epididymis causing its inflammation. Medications such as amiodarone indicated in treatment of cardiac arrhythmias can also cause epididymytis. Bacteria responsible for causing tuberculosis known as mycobacterium tuberculosis can also cause epididymitis in rare cases.
In addition to the above mentioned causative factors, certain conditions such as uncircumcision, structural abnormalities of the urinary tract, indulging in unprotected sexual intercourse with multiple partners and use of urethral catheter regularly can predispose men to develop epididymitis .
Epididymitis is considered to be the 5th most common urologic diagnosis in males between 18 and 50 years of age. It is also the most common cause of intrascrotal inflammation. It has been estimated that about 1 in every 1000 men develop this urologic condition. Statistics have also revealed that acute epididymitis causes more than 600,000 medical visits per year. Acute form of the condition is more common in males aged 20 to 59 years. Epididymitis is also considered to be the frequent cause of military hospitalizations .
Anatomically, epididymis is a coiled tube which is located posterior to the testicles. It is responsible for storing and carrying sperm, connecting the efferent ducts of the testis to the vas deferens. Inflammation of this region due to bacterial infections or any other underlying conditions promotes development of epididymitis. Males suffering from this condition, present with scrotal pain and induration.
Epididymitis can be both acute and chronic in nature. In the acute form, the epididymal pain and swelling can continue for several days. In the latter form, the pain and inflammation of the epididymis can continue for more than 6 weeks with onset of scrotal induration .
Epididymitis is caused by bacterial infections and sexually transmitted diseases. Epididymis should not be confused with testicular torsion which is a urologic emergency . It has been observed that epididymitis is a major and the most frequent cause of acute scrotal pain amongst the male population. The condition can be both acute and chronic in nature requiring prompt diagnosis and treatment.
Epididymitis is characterized by inflammation of the epididymis due to bacterial infections or structural abnormalities. It can strike males of any age and mainly occurs in those who are sexually active. Epididymmitis is considered to be the 5th most common cause of urologic emergency.
Bacterial infections, sexually transmitted infections and structural abnormalities are the major causes of epididymitis. In addition, trauma to the groin can also predispose an individual to develop such a condition. Certain medications can also cause development of epididymitis.
Symptoms of epididymitis include swollen scrotum that is painful and warm and tender to touch. In addition, individuals would also experience painful urination, discharge from penis, painful intercourse, blood in semen and fever.
Diagnosis of epididymitis includes preliminary physical examination to check for signs of enlarged lymph nodes in the groin region. In addition, color Doppler along with ultrasound would be carried out to rule out the condition of testicular torsion.
Treatment is done through antibiotics to ward off the infection. If the condition has occurred due to sexually transmitted infections, then partner would also require treatment. Surgery is method of choice when there is formation of abscess.
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- Lee JY, Lee TY, Park HY, Choi HY, Yoo TK, Moon HS. Efficacy of epididymectomy in treatment of chronic epididymal pain: a comparison of patients with and without a history of vasectomy. Urology. Jan 2011;77(1):177-82.
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