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Epididymitis
Theepididymisisaseriesofsmalltubesattachedtothebackofeachtesticlethatcollectsand storessperm.Oneofthemostcommoncausesofscrotalpainisepididymitis,aninfectionand subsequentinflammationofthesecoiledtubes. Epididymo-orchitisoccurswhentheinfectionspreadstoincludethetesticle. Epididymitisisusuallyasecondarybacterialinfectiontriggeredbyarangeofconditions,suchas urinarytractinfectionsorsexuallytransmissibleinfections(STIs).Thebacteriaintheurethra(the tubethatallowstheexitofurineandspermfromthepenis)simplybacktrackthroughtheurinary andreproductivestructurestotheepididymis. Treatmentoptionsincludeantibioticsandbedrest.Somemendevelopchronicepididymitis,which ischaracterisedbyinflammationevenwhenthereisnoinfection. Symptoms Thesymptomsofepididymitisinclude: Slightfever Chills Asensationofheavinessintheaffectedtesticle Sensitivitytotouchorpressureintheaffectedtesticle Enlargementofthetesticle Abdominalpain Pelvicpain Frequenturgetourinate Aburningsensationonurination Dischargefromthepenis Bloodintheurine Painfulejaculation.

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A range of causes Mostcasesofepididymitisarecausedbybacterialinfection.Someofthecausesinclude: Urinarytractinfections Sexuallytransmissibleinfections(STIs),suchaschlamydiaandgonorrhoea Recentgenito-urinarysurgery,includingprostatectomy Theuseofurinarycatheters Somecongenitalkidneyandbladderproblems.

Possible complications Ifleftuntreated,acuteepididymitiscanleadtoarangeofcomplicationsincluding: Chronic epididymitis persistentinflammation,evenwhenthereisnobacterialinfection. Abscessaballofpusmayaccumulateinsidetheepididymisornearbystructures. Surgeryisneededtodrainthepus. Destruction of the epididymistheinflammationcanpermanentlydamageoreven destroytheepididymisandtesticle.Thiscanleadtoinfertility. Spread of infectiontheinfectionmayescapethescrotumandspreadtoanyother organorsystemofthebody.

Diagnosis

Epididymitis

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Epididymitiscanbehardtodistinguishfromtesticulartorsion,particularlyinyoungermen. Testiculartorsionmeansthetesticlehastwistedandchokedoffitssupplyofblood.Sometimes epididymitisandtesticulartorsioncanoccuratthesametime. Epididymitisisdiagnosedusinganumberoftests,including: Physicalexamination Medicalhistory Urinetests STItests Bloodtests Ultrasound,ifnecessarytodistinguishepididymitisfromtesticulartorsion.

Treatment Thetreatmentoptionsforepididymitisinclude: Acourseofantibiotics Antibioticsforanysexualpartners,ifanSTIwasthecause Bedrest Pain-killingmedication Coldcompressesappliedregularlytothescrotum Elevationofthescrotum Admissiontohospital,incasesofsevereinfection Subsequentcheck-upstoensuretheinfectionhasclearedup.

Chronic epididymitis Somemendevelopchronicepididymitis,whichisinflammationevenwhenthereisnoinfection. Thecauseisunknown,althoughitisthoughtthathypersensitivityofcertainstructures,including nervesandmuscles,maycauseorcontributetothecondition.Someoftheknownriskfactors includegenito-urinarysurgery,exposuretoSTIsandpriorattacksofacuteepididymitis.However, amanwithouttheseriskfactorscanstilldevelopthecondition. Diagnosis of chronic epididymitis Testsareneededtodistinguishchronicepididymitisfromarangeofotherdisordersthatcancause constantscrotalpainsuchastesticularcancer,enlargedscrotalveins(varicocele)oracystwithin theepididymis.Testsmayincludeaphysicalexaminationandultrasoundscan. Treatment of chronic epididymitis Chronicepididymitisisdifficulttotreat.Sincethereisnoinfection,antibioticsdontwork.Someof thetreatmentoptionsmayinclude: Frequentwarmbaths Non-steroidalanti-inflammatorydrugs(NSAIDs) Medicationstorelaxassociatedmuscles Medicationstoalternervemessagestothescrotum Anaestheticorsteroidinjectionsintothescrotum Surgerytoremovetheaffectedepididymis Stressmanagementtechniques.

Where to get help Yourdoctor Urologist FamilyPlanningVictoriaTel.1800013952or(03)92570100www.fpv.org.au

Things to remember Epididymitisisinfectionandsubsequentinflammationoftheepididymis,aseriesofsmall tubesattachedtothebackofeachtesticlethatcollectsandstoressperm. Mostcasesofepididymitisarecausedbybacterialinfectionarisingfromurinarytract infectionsorsexuallytransmissibleinfections(STIs)likegonorrhoeaorchlamydia.

Epididymitis

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Treatmentoptionsincludeantibioticsandbedrest. Somemendevelopchronicepididymitis,whichisinflammationevenwhenthereisno infection.

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Epididymitis

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