WHAT IS EPIDIDYMITIS?

Orchitis is inflammation of the testicle. In some cases, a viral infection called mumps can cause orchitis and lead to swollen testicles.

Often, epididymitis and orchitis occur together, a condition known as epididymo-orchitis. The treatment for both conditions is similar, so they are often collectively referred to as epididymitis.

If you have epididymitis or orchitis, you might experience pain in your testicles or scrotum. Typically, only one testicle is affected, though it can impact both. Additional symptoms include:

• Swelling of the scrotum or testicle
• Redness or warmth of the scrotum
• Discomfort or burning sensation while urinating
• Possible discharge from the penis, especially if the infection is sexually transmitted
• Discomfort during or after ejaculation
• Fever and chills, if the infection has become systemic

If you experience pain or swelling in your testicles or scrotum, you must see a doctor. They will ask about your symptoms and conduct a physical exam. They might also perform several tests, including:

• Urine tests to check for infections.
• An ultrasound imaging test that uses sound waves to create pictures of the structures.
• If there’s discharge from your urethra, a sample may be taken for further testing in the laboratory.

The choice of treatment will depend on the cause of your condition.

If your symptoms are caused by a bacterial infection, your doctor will prescribe antibiotics, which are usually taken at home. Severe infections might require hospital treatment.

If you’re being treated for an STI like chlamydia or gonorrhea, inform your recent sexual partners so they can also be tested and treated. Your doctor might recommend follow-up testing in a few months.

If prescribed antibiotics, complete the entire course and avoid sexual activity until your treatment and your partner’s treatment are finished.

In severe cases, an abscess may form. An abscess is a localized collection of pus in response to infection. Surgery might be necessary to drain the pus or remove part of the epididymis.

At-home symptom management for relief includes:

• Applying a cold gel pack or bag of ice to the area for 15 minutes every few hours to reduce pain and swelling
• Wearing a jock strap to support your scrotum
• Taking over-the-counter pain medications like:
  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
• Limiting activities that could make the condition worse, such as heavy lifting or strenuous exercise

Orchitis and epididymitis can lead to several complications if left untreated. Some of the potential issues that might arise from these conditions include:

1. Testicular atrophy: Orchitis can cause the affected testicle to shrink, which can impact the production of sperm and testosterone.
2. Scrotal abscess: An infected testicle can develop a pus-filled pocket that can cause significant pain and may require surgical drainage.
3. Infertility: In some cases, if both testicles are affected by orchitis or severe or recurrent epididymitis occurs, this can lead to infertility.
4. Chronic epididymitis: If epididymitis persists for more than six weeks or recurs frequently, it is considered chronic and may require long-term management.

Getting the correct diagnosis early on, along with appropriate treatment, can help prevent these complications.

If you’ve been prescribed antibiotics and your symptoms haven’t improved after three days, it’s essential to call your doctor. Not responding to treatment could indicate that the infection is resistant to the prescribed antibiotics or that another underlying issue might need addressing. In addition, consult your doctor if:

• Symptoms return or worsen
• You develop a fever during treatment

If you experience severe pain and cannot reach your doctor, you should go to the emergency department right away. Severe pain can be a sign of a more serious complication, which requires immediate medical attention to prevent long-term damage.

The most effective way to prevent viral orchitis is through vaccination. The MMR (measles, mumps, and rubella) vaccine effectively prevents mumps, a common cause of orchitis.

You can help prevent bacterial orchitis and epididymitis caused by STIs by:

• Using a latex condom every time you have sex
• Avoiding sex when you or your partner have genital symptoms indicating a possible infection

Is epididymitis contagious?

Epididymitis itself is not contagious, but underlying infections, particularly STIs like chlamydia and gonorrhea, are. Practicing safe sex and treating sexual partners can prevent the spread.

How long does it take to recover from epididymitis or orchitis?

Symptoms typically improve within a few days of starting treatment, but full recovery may take several weeks. If pain or swelling persists, discuss it with your urologist.