The epididymis is a tube that connects a testicle to the Vans Deferens – a duct that helps tunnel sperm to the urethra or opening of the penis. When the epididymis becomes infected, it’s called epididymitis.
Sexually active men under the age of 40 are most prone to getting epididymitis. It can be caused by sexually transmitted diseases like gonorrhea, from having unprotected sex but also can be caused by needing to use a catheter often in order to urinate, from injuries to the urinary tract, from TB, as a bad side effect of a heart medication called amiodarone or as a complication from surgery. Using condoms is the best way to prevent this painful condition.
As this condition progresses, the testicle area will become increasingly sensitive to pressure, as well as painful. If an infection develops within the epididymis, it could spread to the testicle.
Epididymitis is most commonly caused by another bacterial infection. This occurs when bacteria moves backwards through the urethra, prostate, vas deferens, and settles in the epididymis. In younger men (those under 40), the bacteria that cause Epididymitis are usually the same bacteria that cause sexually transmitted diseases, like chlamydia. These bacteria are called Chlamydia trachomatis and Neisseria gonorrhea. In older men (those over 40), Epididymitis is more commonly caused by bacteria that already live in the colon, called coliforms. These are the same bacteria that cause bladder infections. Men who regularly have sexual intercourse may also be more likely to get infections from this type of bacteria. In more rare instances, there are other factors that could lead to Epididymitis. This includes having sex with a full bladder, which can cause infection, use of heart medication amiodarone, and some viral infections.
After a physical exam and diagnostic test such as blood tests, urinalysis or an ultrasound of the testicles, doctors will be able to determine if the symptoms are caused by epididymitis or another condition.
A treatment plan usually consists of resting in bed with the scrotum elevated, using ice packs to painful sites and antibiotics. The Centers of Disease Control and Development recommend a regimen of one dose of ceftriaxone and 10 days of doxycycline, unless the cause of epididymitis is from intestinal bacteria. In that case, medication should be levofloxacin or ofloxacin for 10 days. Patients usually start feeling better within 48 hours.
A follow-up doctor’s exam is recommended to make sure the infection is completely gone or if symptoms do not improve or get worse 48 hours after beginning treatment.
WARNING: All sex partners of the patient in the last 2 months before symptoms begin should be contacted and warned that they may need treatment.
To prevent Epididymitis, it is important to take steps to cut your chances of getting a bacterial infection that could cause it. For younger men especially, this means taking steps to prevent contracting STDs that could lead to an infection. The best way to do so is to practice safe sex, use a condom, and ensure you and your partner are regularly tested and practicing safe habits.
For all men, if you experience frequent or recurring bladder infections, you should also speak to a doctor about finding ways to prevent these infections, as they can lead to Epididymitis. As mumps can also lead to Epididymitis, it is important to get a mumps vaccine and be aware of any symptoms or risk factors for it. Men who use the medication amiodarone and experience infections should also speak to a doctor about alternative medications.
For all men, especially those who are uncircumcised, it is important to always practice good hygiene habits.