The epididymis is a small, coiled tube which connects with the vas deferens from the back of the testicles, carrying and storing sperm. When the epididymis becomes inflamed, the area surrounding it may get swollen or painful. This condition is known as epididymitis, and is usually caused by a bacterial infection. Chronic epididymitis describes any case in which symptoms last over six weeks or come back repeatedly over a longer period of time. Epididymo-orchitis describes a condition in which the testicles become inflamed in addition to the epididymis.
The most common causes of epididymitis are bacterial infections or sexually transmitted infections such as chlamydia or gonorrhea. Irritation leading to inflammation can also be caused by reflux of urine into the ejaculatory ducts, or in some cases by the spread of tuberculosis or prostate infections. Chronic anxiety and stress may also increase the severity of epididymitis pain or contribute to recurring pain flare-ups.
Epididymitis is characterized by pain and/or swelling in the scrotum and testicles. The onset of pain is usually gradual, growing worse over time. Patients with epididymitis often report frequent urination or burning during urination. If left untreated, chronic epididymitis may have worsening effects such as unusual penile discharge or flu-like symptoms like fever or chills.
Inflammation of the epididymis is often associated with sexually transmitted infections, so not practicing safe sex can put you at a higher risk. An enlarged prostate can increase your risk of infection leading to epididymitis, and so can some illnesses such as tuberculosis.
Epididymitis can usually be diagnosed by reviewing your symptoms and performing a physical examination of the affected area for swelling or other infection symptoms. Other tests like STI, blood, or urine screenings can help to rule out or identify an enlarged prostate or any infection that may be the underlying cause of inflammation.
Once any underlying infections have been addressed, the next step is to treat the persistent nerve inflammation that is often seen with chronic inflammatory conditions of the genital tract. Our comprehensive outpatient PRM protocol utilizes ultrasound guided peripheral nerve blocks in combination with pelvic floor physical therapy and behavioral modifications to reduce chronic inflammation.
If you are sexually active, it’s important to practice safe sex – use condoms and regularly get tested for sexually transmitted disease, especially if you have multiple sex partners over a short period of time. If you are experiencing pain in your testes, it’s important not to ignore it until it gets worse. Severe pain to the testes or scrotum should be considered an emergency that requires immediate medical attention.
Pain and swelling from chronic epididymitis can continue to worsen over time. There is also the risk of infection spreading to the testicles or other parts of the genital region. If this condition continues to go unaddressed, it may result in reduced sperm count and motility, and can even lead to infertility in some cases.
Epididymitis is one of many conditions which can cause testicular pain, and often results from the presence of another condition such as prostatitis or sexually transmitted infections like gonorrhea or chlamydia.
Epididymitis is a condition in which the coiled tube located at the back of the testes becomes inflamed. It is often caused by bacterial infections or STDs and any treatment plan begins with identifying and treating any of these underlying infections. Our comprehensive outpatient protocol, incorporating lifestyle medicine and other non-pharmacological methods, can help to provide improvement of function and reduction of pain over time. Testicular pain should always be taken seriously and it’s important to notify a doctor immediately in the case of severe genital pain or swelling.