Epididymitis

A Epididymitis or Epididymitis can be a very painful condition due to the sensitivity of the entire area. Although it usually heals without any problems with proper therapy, serious complications can arise without treatment.

What is epididymitis?

Acute epididymitis shows symptoms that are very similar to those of testicular inflammation (orchitis). The first symptoms are often pain when urinating and an increased urge to urinate.
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The Epididymitis, in specialist circles too Epididymitis called, is an infection that is usually caused by viruses or bacteria and affects the epididymis.

Due to the anatomical conditions, the epididymis are located just above the testicles, the epididymis can easily spread to the testicles, so that testicular inflammation can also occur.

The symptoms of epididymitis develop very slowly at the beginning, so that the inflammation can develop very quickly and spread to nearby parts of the body.

causes

A Epididymitis is mostly triggered by bacteria or viruses. In most cases, they enter the body via the urethra and ascend along the seminal ducts to the epididymis. This is also called an ascending infection.

Often the pathogens come from an inflammation of the bladder, prostate or urethra that spreads further in the body. In younger men, epididymitis is also occasionally caused by chlamydia, which is transmitted through unprotected sex.

Other possible causes of epididymitis can, however, also be surgical interventions or a catheter. However, epididymitis can also be triggered by injury to the epididymis. This can happen, for example, due to an accident or a kick.

The epididymis is very rarely infected via the bloodstream. From a source of inflammation elsewhere in the body, the infectious agents travel with the blood to the epididymis and trigger another infection here.

In rheumatism patients, epididymid inflammation can also be a side effect of rheumatism.

Symptoms, ailments & signs

Acute epididymitis shows symptoms that are very similar to those of testicular inflammation (orchitis). The first symptoms are often pain when urinating and an increased urge to urinate. In addition, the testicle swells. The swelling can be so severe that the wrinkles in the skin disappear completely.

Another sign is the significant warming of the affected testicle. It starts to hurt and is particularly sensitive to pressure and touch. The pain can radiate into the abdomen and the groin area. The skin on the scrotum begins to turn reddish, which is another typical sign of inflammation.

A general feeling of illness arises with tiredness and fatigue. Some patients also have a fever of up to 40 degrees, accompanied by chills, nausea and vomiting. At the onset of the disease, the inflammation is clearly delineated and only affects the epididymis.

If treatment does not start immediately, the inflammation often spreads to the testicles after just one day, as the two structures are very close to each other. As a rule, the symptoms are limited to one side, in exceptional cases they can also spread to the second epididymis and testicles. Chronic epididymitis also causes swelling of the testicle, but there is almost no pain. Overall, she shows few symptoms.

Diagnosis & course

Diagnosing a Epididymitis is quite unproblematic after the onset of the first stronger symptoms. Therefore, the diagnosis is made after a greenish examination and anamnesis. There is severe pain in the epididymis. These are accompanied by swelling and warming. It is also possible that the scrotum becomes reddened.

In worse cases, general inflammatory reactions such as chills, fever and states of exhaustion can occur. The diagnosis can be corroborated by various methods. These include: blood and urine tests, ultrasound diagnostics and palpation of the testicles.

With the help of ultrasound diagnostics it can be determined whether the epididymis is already enlarged and whether an abscess has already formed.

Epididymitis usually heals completely with proper treatment. In rare cases, however, it can also spread to the second epididymis or become chronic. This can result in the man concerned being unable to conceive. Possible complications of epididymitis include abscess formation or even blood poisoning.

Complications

As a rule, epididymitis is associated with very uncomfortable pain. The pain from the testicles can spread to the abdomen, back and furthermore to the legs, so that there is a significant reduction in the patient's quality of life. In most cases, the testicles are swollen and noticeably red.

The skin can also be itchy, although the itching is usually only aggravated by scratching. Without treatment, patients experience fever and pain in the extremities. Chills or a general feeling of weakness can also occur due to epididymitis and make everyday life difficult for the patient. In most cases, epididymitis also leads to pain that occurs when urinating.

These are above all burning and can lead to psychological complaints or irritation in the patient. The treatment of epididymitis is usually done with the help of antibiotics. There are no particular complications. The symptoms usually go away after a short time. Epididymitis does not have a negative impact on the patient's life expectancy.

When should you go to the doctor?

If the man suffers from swelling of the testicles, pain when urinating, or unusually full scrotum sacs, a doctor is advised. If there is general restlessness, an increased body temperature and visual genital changes, a doctor should be consulted. If a diffuse pain sensation arises or if existing pain spreads further, a doctor should be consulted. A medical examination is required if you feel generally sick, feel sick or vomit.

The self-determined intake of medication or the use of ointments should only be undertaken in consultation with a doctor. There is a possibility of side effects and contraindications that can be avoided or reduced with optimal therapy. Discomfort when engaging in sexual activities, decreased libido, feelings of shame or withdrawal from the relationship can indicate a disease. A doctor is needed to determine the cause and initiate treatment.

Discoloration of the testicles or other abnormalities in the appearance of the skin in the genital area should be presented to a doctor. Problems with locomotion, touch and sensation disorders, and fatigue should be assessed by a doctor. If exhaustion occurs quickly and emotional or mental irregularities occur, a doctor is required.

Treatment & Therapy

The therapy of Epididymitis should be done as early as possible, this enables complete healing.

First, the affected epididymis can be cooled and elevated. The entire testicle should also be immobilized. Appropriate pain relievers and anti-inflammatory drugs can be taken to combat the general inflammatory reactions. The bacteria that cause epididymitis are fought by using an antibiotic.

In the rare cases of virus-related epididymitis, the administration of special drugs against the viral disease is dispensed with. There is only the therapy mentioned to alleviate the symptoms. In order to prevent a chronic course, care should be taken to carry out the therapy consistently. This allows the epididymis to heal in approximately two to three weeks. However, it may take longer for the affected scrotum to swell.

If the epididymis has already resulted in abscess formation or similar complications, surgical intervention may be necessary. Physical exertion should be avoided to support the therapy.

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Outlook & forecast

Epididymitis above all requires a lot of patience. The healing process can be delayed for up to six weeks, even with correct treatment. Only then does the scrotum feel as usual in many of those affected. Usually, however, epididymitis heals well. However, some complications are possible. This can be, for example, fistulas, the local destruction of the tissue and an expansion of the inflammation to the seminal and urinary tract. Occasionally, an abscess can also develop in the more pronounced epididymis. This has to be eliminated operationally.

Frequent occurrence or displacement can lead to constrictions and scarring in the spermatic duct or epididymis. This hinders the transport of sperm, which can result in infertility, especially with the bilateral closure. In addition, the inflammation could spread to the other testicles. In the case of recurring inflammation, usually only surgical severing of the spermatic cord or removal of the diseased epididymis helps.

In more advanced stages, the testicle itself sometimes has to be removed. In addition to blood poisoning, Fournier's gangrene is a very feared complication that is particularly difficult when the immune system is weakened. This leads to tissue death of the connective tissue in the affected testicle. Which in turn can lead to a severe inflammatory reaction in the body with a very high mortality rate.

prevention

One can Epididymitis difficult to prevent. People with changing sex partners should definitely use condoms, as this prevents infection with chlamydia. Other infections, such as bladder or prostate infections, should be treated early to prevent the infection from spreading.

Aftercare

The therapy of epididymis usually leads to a complete healing. The patient is no longer affected. Since there is no symptom, there is no reason for further follow-up examinations. Infection is possible again at any time.

To prevent this, preventive measures should be observed. The patient is responsible for this himself in the context of aftercare. He is informed by his doctor about suitable behavior. Sexual intercourse should only take place in a protected manner. Symptoms of the prostate and urinary tract should be reported to a doctor immediately. Experience has shown that starting treatment at an early stage leads to the best chances of recovery.

Epididymitis takes a chronic course in some patients. Then permanent aftercare is necessary. It is important to prevent complications such as an abscess or blood poisoning. Infertility can also develop. The doctor and the person concerned agree on a rhythm of presentations.

Medicinal treatment to reduce pain is also provided. As part of a follow-up appointment, the doctor palpates the testicles and scrotum sacs. This is followed by a blood or urinalysis. This gives rise to the inflammation values. In certain cases, an ultrasound and x-ray may also be indicated. A detailed follow-up is usually used to discuss the question of an operation.

You can do that yourself

Epididymitis is very uncomfortable for those affected, but it heals relatively quickly. For relief, the swollen testicle should be raised up. This is z. B. achieved by a so-called jockstrap. This jockstrap is a special carrying bag that "catches" the affected scrotum. This prevents the diseased testicle from being pulled down by its own weight and causing pain. Instead, he is exonerated.

Close-fitting underwear should also be worn. This also gives "stability" to the swollen scrotum and reduces pain. Boxer shorts or similar should be avoided in the acute pain phase. Most people affected will find it extremely pleasant when the swollen testicle is cooled. You can use a cold washcloth or envelopes. However, ice-cold water or even ice must never be used. This would only damage or destroy the surrounding tissue even more.

Rest and a lying position in which the legs are elevated also have a pain-relieving effect. During this time you should refrain from exercising or exerting yourself. If the inflammation and the pain associated with it are so severe that pain medication is necessary, relief can be achieved by taking ibuprofen.