Epididymitis – Symptoms, Diagnosis, Stages and Treatment
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Although most common in sexually active men between the ages of 18-35, and often caused by one of the bacterial infections such as: chlamydia, gonorrhea, or non-gonococcal urethritis – epididymitis can also affect older men too. However, when this is the case, it is often caused by a viral infection, and less so due to a bacterial one.
What is epididymitis?
When the epididymis, a single, narrow, tightly coiled tube that can be found just behind the testicles, and forms part of the male reproductive process which holds the male sperm becomes infected by either a bacteria or virus, the name given to the condition is epididymitis. The epididymis can grow to a length of some 7-meters, and consists of a head, body, and tail.
And although this condition is not usually seen as being life threatening, if left untreated can become rather uncomfortable to the sufferer, as any individual who has experienced it knows.
Symptoms – may include: a low-grade fever, chills, a heavy sensation in the area of the testicle that becomes sensitive to pressure, scrotal swelling or lumps, a discharge from the tip of the penis (the urethra), a dull pain or discomfort in the lower abdomen, pelvis, or groin area, and pain during sexual intercourse (especially during ejaculation).
Diagnosis – usually includes: a physical examination that may discover a small lump (mass) on the affected side of the scrotum (usually on the left-side, and less commonly found on the right), tenderness in the area where the epididymis is attached to the testicle, enlarged lymph nodes in the area of the groin, and a noticeable discharge coming from the tip of the penis. This may be followed by:
1. A rectal examination that often shows the prostate to be either swollen or tender.
2. Blood tests ([CBC] complete blood count).
3. A Doppler ultrasound test that uses reflected sound waves to evaluate the blood as it flows through the vessels.
4. A testicular scan ([nuclear medicine scan] after a radio-active tracer [radionuclide or radioisotope] has been administered into the body, a special camera [gamma] takes pictures that can show activity and function of the tissues found around the testicles, and of the testicles themselves).
5. Urine tests ([urinalysis] initial, and mid stream).
6. STD (sexually transmitted disease) tests for both chlamydia and gonorrhea.
These tests will also distinguish between epididymitis and testicle torsion which is another condition, and one that usually needs surgery to be treated.
Stages – If epididymitis has been present for longer than 6-weeks, it is usually classified as acute (chronic epididymitis).
Treatment – that is considered for epididymitis caused by a bacterial infection is usually a course of antibiotics, such as: Ceftriaxone 250 mg IM taken in a single dose, and usually accompanied by Doxycycline 100 mg taken orally twice a day for a period of 10 days.
However, when the epididymitis is caused by a viral infection, Levofloxacin 500 mg is usually prescribed to be taken orally once daily for a period of 10 days, or Ofloxacin 300 mg taken orally twice a day for the same period of time.
Sometimes acute epididymitis can be difficult to treat, and when this is the case, alternative medicines such as homeopathy treatments may be a good option.
These treatments may include: Atropa Belladonna 200C, and Pulsatilla Nigricans 30C taken together (three tablets of each) 3-times a day for a period of up to 6-months.
As a last result, surgery may be offered to remove the epididymis completely; however, this is usually only after previous treatments have shown little or no success. Once the epididymis has been removed, the man will no longer be able to bear children.