Epididymitis Health Article

Definition

Epididymitis is the inflammation or infection of the epididymis, the long coiled tube that attaches to the upper part of each testicle. The epididymis functions as a storage, transport, and maturation place for sperm before ejaculation.

Description

In adults, epididymitis is the most common cause of pain in the scrotum, and in adolescents, the second most common cause. The acute form is usually associated with the most severe pain and swelling. If symptoms last for more than six weeks after treatment begins, the condition is considered chronic.

Epididymitis is most common between the ages of 18 and 40, but children can get it, too. Boys who experience painful urination, have a history of urinary tract infections, abnormal bladder function, or abnormalities of the genitals and urinary structures are more inclined to get epididymitis. It is seldom found in adolescents who aren't sexually active.

The infection is especially common among members of the military who exercise for extended periods without emptying their bladders.

Factors that increase the risk of developing epididymitis include:

• infection of the bladder, kidney, prostate, or urinary tract
• other recent illness
• narrowing of the urethra (the tube that drains urine from the bladder)
• use of a urethral catheter

The infection doesn't start in the epididymis. It is an ascending infection that most often starts in the urethra or urinary tract before spreading to the epididymis.

Causes & symptoms

Among men under age 35 who are sexually active, Chlamydia trachomatis or Neisseria gonorrhoeae are the most common causes of epididymitis.

Nonsexually transmitted epididymitis is associated with urinary tract infections and is more common in men who have undergone surgery for urinary tract problems or who have anatomical abnormalities.

Although epididymitis is often caused by and associated with some of the same organisms that cause some sexually transmitted diseases, there are other causes as well. The condition can also be attributed to pus-generating bacteria associated with infections in other parts of the body. This cause, however, is rare.

Epididymitis can also be caused by injury or infection of the scrotum or by irritation from urine that has accumulated in the vas deferens (the duct through which sperm travels after leaving the epididymis).

Epididymitis is characterized by pain in the testes. The pain, which usually develops gradually over several hours or days, is followed by sudden redness and swelling of the scrotum. Generally, only one testicle is affected. The affected testicle is hard and sore, and the other testicle may feel tender. The patient has chills, a low-grade fever, and usually has acute urethritis (inflammation of the urethra).

Sometimes, there is a discharge from the urethra and blood in the semen. Ejaculation can be painful.

Enlarged lymph nodes in the groin cause scrotal pain that intensifies throughout the day and may become so severe that walking normally becomes impossible.