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Definition of Epididymitis and Causes
Inflammation of the epididymis, nearly always due to infection. The epididymis is a tightly coiled tubule that begins at the base of the testicle and ends at the vas deferens. The epididymis incubates newly formed sperm, bringing them to maturation as they migrate through its coils on their journey to the vas deferens.
Escherichia coli infection, chlamydia, and gonorrhea are the most common causes of epididymitis E. coli in young boys and men over age 60; chlamydia and gonorrhea in men between ages 25 and 50. Repeated infections may result in permanent infertility.
Symptoms typically include scrotal pain and swelling, discharge from the penis, and difficulty urinating. Some men also experience fever, nausea, and pain extending into the sides of the abdomen (the flank area). The diagnostic path includes examination to rule out testicular torsionand culture of the discharge to identify the responsible pathogen.
Treatment is a course of the appropriate antibiotic medications when the infection is bacterial. As with all infections, it is essential to complete the entire prescribed course of antibiotics even when symptoms improve. Less commonly, viruses (such as the mumps virus) may cause epididymitis. Viral epididymitis resolves without treatment (antibiotic medications cannot treat viral infections).
The doctor may recommend analgesic medications such as acetaminophen or nonsteroidal antiinflammatory drugs (nsaids) such as ibuprofen to relieve discomfort and fever; NSAIDs can also relieve inflammation. Ice packs or cold cloths applied to the scrotum and supporting the scrotum such as by wearing an athletic supporter may also provide relief.
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