Why men should understand epididymitis and orchitis

There are a couple of conditions men are vulnerable to that they may not be familiar with – epididymitis and orchitis.  Both conditions can cause pain in the scrotum or testicle and can occur either separately or together at the same time. 

What is epididymitis?

 Epididymitis is not a commonly known condition but once a man has it, he probably won’t forget it.  More than 60,000 men in the United States visit an emergency room due to this problem.  Epididymitis is an inflammation involving the epididymis, a long, narrow tube tightly coiled at the back of the testicles which store and carry sperm.

Men who are most affected by epididymitis are sexually active men in their 20s and 30s yet it can strike men of any age and who are celibate.  This condition is most often caused by a bacterial infection including sexually transmitted infections such as gonorrhea or chlamydia.  When it occurs in children or older men, it is usually caused by E. coli and similar bacteria.  A medicine used to prevent abnormal heart rhythms called Amiodarone or Pacerone can be another cause of it. Sometimes trauma to the groin can result in epididymitis or when a man does heavy lifting causing urine to flow backward into the epididymis.

Signs of epididymitis

There can be many signs and symptoms of a man with epididymitis which include:

·      Urinary burning and increased frequency

·      Penile discharge

·      A swollen, red or warm scrotum

·      Testicle pain and tenderness, usually on one side

·      A fever

·      Painful intercourse or ejaculation

·      A lump on the testicle

·      Pain or discomfort in the lower abdomen

·      Blood in the semen

Getting epididymitis diagnosed

Anytime a man has scrotal pain or swelling, or discharge from his penis or pain when urinating, needs to see his doctor.  There are a number of reasons for scrotal pain and in order to prevent permanent damage, it needs to be checked out as soon as possible.

When the pain is severe, go to the emergency room right away. 

A doctor will do a physical exam, checking for enlarged lymph nodes in the groin area and may do a rectal exam to check for prostate enlargement.  Blood and urine samples will be analyzed for abnormalities and an ultrasound may be used to rule out testicular torsion. 

Once epididymitis is diagnosed, men often require bed rest with a scrotal support for comfort.  Antibiotics will be prescribed along with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen.  The entire course of the antibiotic prescribed needs to be taken to completely eliminate the bacteria.  If the cause of the infection is due to a sexually transmitted infection, a man’s sexual partner will need to be treated also. 

It may take several weeks for tenderness in the groin area to completely disappear.  It is important for men to rest, wear an athletic strap to support the scrotum, apply ice packs and take pain medications to relieve discomfort. 

A follow-up visit with a man’s doctor is recommended to make sure the infection has completely cleared up.  Most men will have epididymitis clear up within three months with no long-term sexual or reproductive problems in most cases. 

What is orchitis?

Orchitis is a swelling or pain in one or both testicles, usually from an infection or virus.  The cause of orchitis is usually from the spread of bacteria through the blood from other locations in the body.  But it can also be a progression of epididymitis, an infection of the tube that carries semen out of the testicles.  When they occur together, it is called epididymo-orchitis. 

Symptoms of orchitis

When a man has orchitis, there is a rapid onset of pain in one or both testicles that may spread to the groin.  The symptoms may include the following:

·      One of both testicles may appear tender, swollen, and red or purple

·      A “heavy feeling” in the swollen testicle

·      Blood in the semen

·      High fever, nausea, vomiting, pain with urination or pain from straining with a bowel movement, groin, pain, or pain with intercourse

Treatment for orchitis

Any man experiencing the symptoms of orchitis needs to see his primary care physician as soon as possible for an accurate diagnosis.  The majority of cases of orchitis and epididymo-orchitis require antibiotics.  Antibiotics will cure the infection and prevent its spread.