What are the common symptoms of epididymitis. How is epididymitis diagnosed and treated. Can epididymitis be prevented. What is the long-term outlook for men with epididymitis.

Understanding Epididymitis: A Common Cause of Groin Pain in Men

Epididymitis is a condition characterized by inflammation of the epididymis, a coiled tube located at the back of the testicle responsible for storing and transporting sperm. This inflammation can lead to intense pain in the testicle and groin area, affecting men of all ages but most commonly those between 14 and 35 years old. With an estimated 600,000 cases annually in the United States, epididymitis is a significant health concern that requires prompt attention and appropriate treatment.

Identifying the Symptoms: When to Suspect Epididymitis

Recognizing the symptoms of epididymitis is crucial for early diagnosis and treatment. The most common signs include:

• Pain in the scrotum, potentially spreading to the groin
• Swelling and redness of the affected testicle
• Presence of blood in the semen
• Fever and chills
• Pain or discomfort during urination

Is testicular pain always indicative of epididymitis? While testicular pain can be a symptom of various conditions, persistent pain accompanied by swelling and redness should prompt a medical evaluation to rule out epididymitis or other serious conditions.

Unveiling the Causes: What Triggers Epididymitis?

Understanding the underlying causes of epididymitis is essential for both prevention and treatment. The condition is primarily triggered by:

1. Bacterial infections, often caused by Mycoplasma or Chlamydia
2. Sexually transmitted infections
3. E. coli bacteria
4. Viral infections, such as mumps
5. Rarely, tuberculosis

Additionally, epididymitis can occur due to non-infectious factors, including:

• Retrograde flow of urine into the epididymis, often resulting from heavy lifting
• Urethral blockage
• Enlarged or infected prostate gland
• Catheter use
• Traumatic groin injury

Does engaging in unprotected sexual activity increase the risk of epididymitis? Yes, unprotected sexual encounters can significantly raise the likelihood of contracting sexually transmitted infections that may lead to epididymitis, emphasizing the importance of safe sexual practices.

Diagnostic Approaches: How Doctors Confirm Epididymitis

Accurate diagnosis of epididymitis involves a combination of physical examination and diagnostic tests. The process typically includes:

1. A thorough physical examination of the scrotum to identify tender areas or lumps
2. Urinalysis to detect the presence of bacteria in urine
3. In some cases, an ultrasound of the scrotum for detailed imaging

Why is prompt diagnosis crucial in cases of suspected epididymitis? Early and accurate diagnosis allows for timely treatment, reducing the risk of complications and potential long-term effects on fertility.

Treatment Strategies: Combating Epididymitis Effectively

The treatment of epididymitis aims to address the underlying cause and alleviate symptoms. Key components of the treatment plan include:

• Antibiotic therapy, typically lasting 1-2 weeks, with commonly prescribed medications such as doxycycline, ciprofloxacin, levofloxacin, or trimethoprim-sulfamethoxazole
• Rest and elevation of the scrotum
• Application of ice packs to reduce swelling and discomfort
• Increased fluid intake
• Use of anti-inflammatory medications for pain management

How long does it take for epididymitis symptoms to improve with treatment? Most men experience significant relief within 3 days of starting treatment, although complete resolution of symptoms may take several weeks to months.

Potential Complications: Understanding the Risks of Untreated Epididymitis

Left untreated, epididymitis can lead to serious complications, including:

• Formation of an abscess in the scrotum
• Rupture of the scrotal skin due to severe swelling and infection
• In rare cases, fertility issues

Can epididymitis cause permanent damage to fertility? While rare, chronic or severe cases of epididymitis may potentially impact fertility, underscoring the importance of prompt treatment and follow-up care.

Preventive Measures: Reducing the Risk of Epididymitis

Taking proactive steps can significantly lower the risk of developing epididymitis. Key preventive measures include:

1. Consistent use of condoms during sexual activity
2. Avoiding strenuous lifting or physical exertion
3. Minimizing prolonged periods of sitting
4. Maintaining good hygiene practices
5. Seeking prompt treatment for urinary tract infections or sexually transmitted diseases

Are there specific occupations or activities that increase the risk of epididymitis? Occupations or hobbies involving heavy lifting or prolonged periods of sitting may elevate the risk, highlighting the importance of proper ergonomics and regular movement.

Long-Term Outlook: Prognosis for Men with Epididymitis

The prognosis for men diagnosed with epididymitis is generally favorable. With appropriate treatment:

• Most patients experience significant improvement within 3 days of starting antibiotics
• Complete resolution of symptoms may take several weeks to months
• Long-term complications are rare when treatment is prompt and complete

Why is follow-up care important after treatment for epididymitis? Follow-up appointments allow healthcare providers to ensure complete resolution of the infection and rule out other potential conditions, such as testicular tumors or cancer.

Recognizing Recurrent Epididymitis: When to Seek Additional Care

While most cases of epididymitis resolve with proper treatment, some men may experience recurrent episodes. Factors contributing to recurrence include:

• Incomplete antibiotic treatment
• Underlying anatomical abnormalities
• Chronic prostate infections
• Immune system disorders

Should men with recurrent epididymitis undergo additional testing? Yes, recurrent episodes may warrant further investigation, including advanced imaging studies or urological evaluations to identify any underlying structural or functional issues contributing to the condition.

Impact on Sexual Health: Addressing Concerns and Misconceptions

Epididymitis can have temporary effects on sexual health and function. Common concerns include:

1. Pain during sexual activity
2. Temporary decrease in libido
3. Anxiety about transmitting infection to partners

Is it safe to engage in sexual activity during treatment for epididymitis? It’s generally recommended to abstain from sexual activity until the completion of antibiotic treatment and resolution of symptoms to prevent potential transmission and allow for proper healing.

Lifestyle Modifications: Supporting Recovery and Prevention

Adopting certain lifestyle changes can aid in recovery from epididymitis and reduce the risk of recurrence:

• Wearing supportive underwear to minimize testicular movement
• Practicing stress-reduction techniques to support overall immune function
• Maintaining a balanced diet rich in anti-inflammatory foods
• Staying hydrated to promote urinary tract health
• Avoiding activities that may cause trauma to the groin area

Can dietary changes impact the recovery from epididymitis? While no specific diet has been proven to directly affect epididymitis, a balanced, nutrient-rich diet can support overall immune function and potentially aid in the recovery process.

Epididymitis in Special Populations: Considerations for Different Age Groups

While epididymitis can affect men of all ages, certain considerations are important for different age groups:

Adolescents and Young Adults:

• Higher risk due to increased sexual activity
• Importance of sexual education and STI prevention
• Potential impact on fertility concerns

Middle-Aged and Older Men:

• Increased risk due to prostate enlargement
• Consideration of underlying urological conditions
• Potential interactions with other medications

Are there age-specific treatment approaches for epididymitis? While the core treatment remains similar, healthcare providers may adjust antibiotic choices or dosages based on age, overall health status, and potential drug interactions in older patients.

Emerging Research: New Insights into Epididymitis Management

Ongoing research continues to enhance our understanding and management of epididymitis. Recent areas of focus include:

1. Development of more targeted antibiotic therapies
2. Exploration of anti-inflammatory treatments to reduce symptom duration
3. Investigation of potential links between epididymitis and other urological conditions
4. Improved diagnostic techniques for faster and more accurate identification

How might future treatments for epididymitis differ from current approaches? Future therapies may involve more personalized treatment plans based on specific bacterial strains, as well as combination therapies that address both the infectious and inflammatory aspects of the condition more effectively.

Patient Education: Empowering Men to Recognize and Respond to Epididymitis

Educating men about epididymitis is crucial for early detection and treatment. Key points to emphasize include:

• The importance of seeking prompt medical attention for testicular pain
• Understanding the link between sexual health and epididymitis risk
• Recognizing the signs of potential complications
• The value of completing prescribed antibiotic courses
• Strategies for prevention, including safe sex practices and lifestyle modifications

What role do healthcare providers play in patient education regarding epididymitis? Healthcare providers are instrumental in offering clear, accurate information about epididymitis, its causes, treatments, and prevention strategies, helping to dispel myths and reduce the stigma associated with the condition.

Global Perspective: Epididymitis Across Different Healthcare Systems

The approach to diagnosing and treating epididymitis can vary across different countries and healthcare systems. Factors influencing these differences include:

1. Availability of diagnostic tools and treatments
2. Prevalence of antibiotic-resistant strains in different regions
3. Cultural attitudes towards sexual health and seeking medical care
4. Integration of traditional medicine practices in some cultures

How do global variations in healthcare access impact the management of epididymitis? Disparities in healthcare access can lead to differences in diagnostic accuracy, treatment timeliness, and overall outcomes, highlighting the need for improved global health initiatives focused on urological health.

Epididymitis: Symptoms, Causes, Treatments

Overview

Male urinary system

What is epididymitis?

Epididymitis is inflammation (swelling and irritation) of the epididymis, a tube at the back of the testicle that carries sperm. This swelling can cause intense pain in the testicle. It can occur in men of any age, though it happens most often in men between the ages of 14 and 35. There are an estimated 600,000 cases of epididymitis in the United States each year.

Symptoms and Causes

What causes epididymitis?

Most cases of epididymitis are caused by an infection, usually by the bacteria Mycoplasma or Chlamydia. These infections often come by way of sexually transmitted diseases. The bacterium E. coli can also cause the condition. Other infections, including with the mumps virus and, rarely, tuberculosis, can also cause epididymitis.

Sometimes epididymitis occurs when urine flows backward into the epididymis. This can happen as a result of heavy lifting. Other causes of epididymitis include:

• Blockage in the urethra (the tube that carries urine from the body)
• An enlarged or infected prostate gland (a muscular, walnut-sized gland that surrounds part of the urethra)
• Use of a catheter (a tube that drains the bladder)
• Traumatic groin injury

What are the symptoms of epididymitis?

Symptoms of epididymitis include:

• Pain in the scrotum, sometimes moving to the rest of the groin
• Swelling and redness in the testicle
• Blood in the semen
• Fever and chills
• Pain when urinating

Diagnosis and Tests

How is epididymitis diagnosed?

To diagnose epididymitis, the doctor will do a physical exam, and will examine the scrotum to look for a tender area or lump. The doctor may also order a urinalysis (urine test) to look for bacteria in the urine. In some cases, doctors use an imaging test called an ultrasound to examine the scrotum.

Management and Treatment

How is epididymitis treated?

Epididymitis caused by bacteria is treated with antibiotics, most often doxycycline (Oracea®, Monodox®), ciprofloxacin (Cipro®), levofloxacin (Levaquin®), or trimethoprim-sulfamethoxazole (Bactrim®). Antibiotics are usually taken for 1 to 2 weeks.

Men who have epididymitis can also relieve their symptoms by:

• Resting
• Elevating the scrotum
• Applying ice packs to the affected area
• Drinking fluids
• Taking anti-inflammatory medications for the pain

What are complications of epididymitis?

If epididymitis is not treated, complications can develop, including an abscess (pus-filled sac) in the scrotum. The scrotum’s skin may open because of swelling and infection.

In rare cases, epididymitis can cause fertility problems in men. Early diagnosis and treatment can help prevent these complications.

Prevention

Can epididymitis be prevented?

You can reduce your risk of developing epididymitis by:

• Using condoms during sex
• Avoiding strenuous lifting or physical activity
• Minimizing long periods of sitting

Outlook / Prognosis

What is the outlook for men who have epididymitis?

Epididymitis usually does not cause any long-term problems. Most men who are treated for the condition start to feel better after 3 days, though discomfort and swelling may last weeks or even months after finishing antibiotic treatment.

It is important to finish the entire treatment recommended by your doctor. If symptoms return, follow up with your doctor. Follow-up can rule out other conditions, including a tumor or testicular cancer.

Living With

When should I call my doctor about epididymitis?

Call your doctor if you develop any symptoms of epididymitis. If your doctor confirms that your infection comes from a sexually transmitted disease, be sure to let recent sex partners know so that they can be examined and treated.

Epididymitis: Symptoms, Causes, Treatments

Overview

Male urinary system

What is epididymitis?

Epididymitis is inflammation (swelling and irritation) of the epididymis, a tube at the back of the testicle that carries sperm. This swelling can cause intense pain in the testicle. It can occur in men of any age, though it happens most often in men between the ages of 14 and 35. There are an estimated 600,000 cases of epididymitis in the United States each year.

Symptoms and Causes

What causes epididymitis?

Most cases of epididymitis are caused by an infection, usually by the bacteria Mycoplasma or Chlamydia. These infections often come by way of sexually transmitted diseases. The bacterium E. coli can also cause the condition. Other infections, including with the mumps virus and, rarely, tuberculosis, can also cause epididymitis.

Sometimes epididymitis occurs when urine flows backward into the epididymis. This can happen as a result of heavy lifting. Other causes of epididymitis include:

• Blockage in the urethra (the tube that carries urine from the body)
• An enlarged or infected prostate gland (a muscular, walnut-sized gland that surrounds part of the urethra)
• Use of a catheter (a tube that drains the bladder)
• Traumatic groin injury

What are the symptoms of epididymitis?

Symptoms of epididymitis include:

• Pain in the scrotum, sometimes moving to the rest of the groin
• Swelling and redness in the testicle
• Blood in the semen
• Fever and chills
• Pain when urinating

Diagnosis and Tests

How is epididymitis diagnosed?

To diagnose epididymitis, the doctor will do a physical exam, and will examine the scrotum to look for a tender area or lump. The doctor may also order a urinalysis (urine test) to look for bacteria in the urine. In some cases, doctors use an imaging test called an ultrasound to examine the scrotum.

Management and Treatment

How is epididymitis treated?

Epididymitis caused by bacteria is treated with antibiotics, most often doxycycline (Oracea®, Monodox®), ciprofloxacin (Cipro®), levofloxacin (Levaquin®), or trimethoprim-sulfamethoxazole (Bactrim®). Antibiotics are usually taken for 1 to 2 weeks.

Men who have epididymitis can also relieve their symptoms by:

• Resting
• Elevating the scrotum
• Applying ice packs to the affected area
• Drinking fluids
• Taking anti-inflammatory medications for the pain

What are complications of epididymitis?

If epididymitis is not treated, complications can develop, including an abscess (pus-filled sac) in the scrotum. The scrotum’s skin may open because of swelling and infection.

In rare cases, epididymitis can cause fertility problems in men. Early diagnosis and treatment can help prevent these complications.

Prevention

Can epididymitis be prevented?

You can reduce your risk of developing epididymitis by:

• Using condoms during sex
• Avoiding strenuous lifting or physical activity
• Minimizing long periods of sitting

Outlook / Prognosis

What is the outlook for men who have epididymitis?

Epididymitis usually does not cause any long-term problems. Most men who are treated for the condition start to feel better after 3 days, though discomfort and swelling may last weeks or even months after finishing antibiotic treatment.

It is important to finish the entire treatment recommended by your doctor. If symptoms return, follow up with your doctor. Follow-up can rule out other conditions, including a tumor or testicular cancer.

Living With

When should I call my doctor about epididymitis?

Call your doctor if you develop any symptoms of epididymitis. If your doctor confirms that your infection comes from a sexually transmitted disease, be sure to let recent sex partners know so that they can be examined and treated.

Why Does My Groin Hurt? 10 Possible Causes of Groin Pain

What Is Groin Pain?

Groin pain is discomfort that happens where the inside of your upper thigh and your abdomen come together. It’s not the same as pain in your testicles, though that can sometimes cause pain that can spread to your groin.

Common Groin Pain Causes

Most often, groin pain is the result of a muscle, ligament, or tendon strain. This happens to a lot of men who play sports. The pain may happen right away, or it could build over time. Continuing the sport or activity may make the injury worse.

There are other conditions that can cause groin pain, including:

Inguinal hernia: This happens when fat or a loop of your intestine pushes through a weak spot in the muscles of your lower abdomen (belly). You may see a bulge in your groin or scrotum. One quarter of all men will develop this problem sometime during their lifetime. If the intestine or fat gets stuck in the abdominal muscle wall, its blood supply may get cut off. That’s called a strangulated hernia.

Symptoms can include:

Get urgent care if you have any of these symptoms. A strangulated hernia is a life-threatening emergency.

Surgery can fix a hernia.

Prostatitis: This is swelling or infection in your prostate gland. In addition to pain, you may have a hard time peeing.

See your doctor. Prostatitis can sometimes go away on its own. But if it’s caused by an infection, you may need to take antibiotics.

Epididymitis: This is swelling in the tube where sperm is stored — the epididymis. Most often, an infection causes it. Signs and symptoms can include:

• Pain on one side of the scrotum that comes on slowly.
• Pain while peeing
• Fever
• Milky discharge from your penis

Orchitis: It’s swelling in one or both testicles that can cause fertility problems. The same infection that’s behind epididymitis may cause orchitis. The two conditions can happen at the same time. Sometimes, the mumps virus triggers orchitis.

If bacteria is the cause of either condition, an antibiotic can clear it up.

Testicular torsion: This happens when a testicle gets twisted inside your scrotum. It may feel like you got kicked in the crotch. It’s a medical emergency. The twisting (torsion) cuts off the blood supply to your testicle. If it’s not surgically untwisted within a few hours, your testicle can die. It happens most often in teen boys.

Testicular cancer: Most of the time, this cancer causes a painless lump in or on your testicle. But sometimes, it’s painful. It’s not a common cancer. If it’s found early, it’s almost always treated and cured.

Hip problems: Sometimes, hip pain from arthritis or another problem can radiate to your groin. It usually builds slowly and may feel worse when you’re driving or sitting in a low chair. Usually, a doctor will try physical therapy and anti-inflammatory medications first to treat the problem. You may need an operation if these don’t work.

Kidney stones: These are small crystals that form in your kidney and can get stuck in tubes leading to your bladder. The pain can be severe. It’s usually in your back or belly, but it can be in your scrotum or at the tip of your penis, too. If the stone is really big, you may need surgery.

Kidney infection: This usually happens when an infection travels from your bladder and enters one or both of your kidneys. Symptoms may include groin pain, frequent urination, and blood or pus in your pee. The bacteria called E. coli is often to blame. Kidney infections are treated with antibiotics.

When to Call the Doctor

Call 911 if you have:

• Testicle pain that’s sudden or intense
• Pain that radiates to your back, abdomen, or chest
• Discomfort along with fever, chills, and nausea

Make an appointment with your doctor if:

• The groin pain is very bad, or it doesn’t get better in a few days.
• There’s swelling or a lump around or in your testicle.
• Pain in your side moves into your groin and testicle.
• There’s blood in your urine.

Groin Pain Diagnosis

If you think you may have groin pain, your doctor will ask:

• When the pain started
• What activities you do regularly
• If anything makes your pain better or worse.

Your doctor will also want to give you a physical exam to rule out other conditions. They’ll also test things like your range of motion and your strength. If they think you might have a groin injury, they may use imaging tests like X-ray and ultrasound to find the problem.

Groin Pain Treatment

If another medical condition causes your groin pain, your doctor will treat that first with medicines, surgery, or both.

If a strain causes your groin pain, your doctor can recommend a physical therapist. They can help you do a mix of stretching and strengthening exercises. They can also wrap your groin area, either with compression clothing or with athletic tape, to help ease swelling. In some cases, they can also teach you how to wrap your groin area yourself.

Over-the-counter pain relievers like acetaminophen or ibuprofen can help you feel better, too. If your injury is more serious, your doctor can prescribe stronger pain relievers.

There are also things you can do at home to feel more comfortable. You can:

• Pause any athletic activities that you normally do to give your groin a chance to heal. For many, rest is the most important thing you can do to help your pain go away.
• Put ice where you feel pain using either an ice pack wrapped in cloth or a bag of frozen peas. You should do this for 20 to 30 minutes a few times a day for a few days, or until swelling goes down.

In some cases of groin pain due to strain, if other treatments don’t work, you may need surgery to feel better.

Groin Pain Prevention

Groin pulls can be painful, and they can keep you away from activities you love. There are ways that you can help prevent groin pulls that result from strains:

• Warm up your legs and groin muscles before any physical activity. A light jog or other activities to get your body temperature up can lower your chances of muscle stains.
• Wear shoes that are comfortable with good support.
• Raise the intensity of your training slowly.
• Stop exercising if you feel pain or tightness in your groin or the inside of your thigh.
• Do regular strengthening exercises for your thigh muscles, especially if you’ve had a groin pull before.

Ask your doctor about other things you can do to make groin pulls less likely.

8 causes and when to see a doctor

Testicular pain can have several causes, from infections to traumatic injuries. Sometimes, testicular pain can be a medical emergency.

In this article, learn about the possible causes of testicular pain, as well as when to see a doctor.

Hernias occur when tissue pushes through a weak part of the abdominal muscles. An inguinal hernia is one type of hernia that can push into the scrotum, causing testicular pain and swelling.

Doctors may be able to reduce or push an inguinal hernia back into place. If this is ineffective, they can correct the hernia with surgery.

Kidney stones can cause pain that radiates to the testicles. Doctors call this referred pain, where the pain occurs beyond the area that is causing the problem.

Other symptoms that doctors may associate with kidney stones include:

• blood-tinged urine
• burning when urinating
• nausea
• pain at the top of the penis
• sharp, cramping pain that may radiate from the back to the groin
• urinating frequently
• vomiting

Doctors may advise waiting for the kidney stones to pass. However, if a stone has not passed after some time or a person starts to experience symptoms of an infection, such as a fever or discharge, they should seek treatment as soon as possible.

Treatments can include surgery to remove the stone or shock-wave lithotripsy, which delivers shock waves to break up the stones.

Orchitis is an infection and inflammation of the testicle. Untreated epididymitis can lead to orchitis.

Symptoms of orchitis can include:

• fatigue
• fever
• nausea
• testicular pain
• swelling in one or both testicles
• vomiting

People should seek immediate treatment for orchitis. Sometimes the pain can be so severe that it is similar to testicular torsion, which is a medical emergency.

Treatments for orchitis depend upon the underlying cause. A doctor can prescribe antibiotics for bacterial infections. When a virus causes orchitis, they can recommend supportive treatments, such as over-the-counter pain relievers, rest, and elevating the scrotum.

Testicular torsion is a serious medical condition that occurs when the testicle twists around the spermatic cord. The spermatic cord carries sperm from the testicles to the urethra.

Typically, testicular torsion is a condition that is more common in young men, usually those under age 25 years.

Symptoms that doctors associate with testicular torsion include:

• nausea
• redness or darkening of the scrotum
• sudden, severe pain that occurs on one side of the scrotum
• swelling in the scrotum
• vomiting

The pain from testicular torsion is not always sudden. Some people with this condition experience pain that slowly worsens over several days.

According to the American Urological Association, testicular torsion typically occurs on the left side more than the right.

Treatment involves surgery to correct the testicular twisting. In rare cases, if a surgeon cannot repair the torsion, they may remove the testicle.

Usually, testicular torsion only affects one testicle, so removing it does not affect a person’s fertility.

A testicular tumor can cause pain and swelling in the testicular area. Other symptoms may include:

• a dull ache in the groin
• a lump in the testicle
• testicular swelling

Symptoms of a testicular tumor can resemble several other conditions that affect males, such as inguinal hernias and epididymitis. A doctor can help diagnose the tumor or other underlying condition.

A blow to the testicles can cause bruising, pain, and swelling. A testicle can also rupture or develop a hematocele. A hematocele occurs when blood pools around the testicle and presses on it, affecting blood flow.

If a person has experienced a blow to the testicles and is experiencing pain and swelling, it is best to seek urgent medical attention.

Varicoceles are abnormally large or twisted veins in the testicles. Sometimes, varicoceles do not cause any symptoms.

When they do, a person may notice testicular pain that gets worse with physical activity or over the day. Varicoceles may also affect a person’s fertility.

Doctors do not know what causes varicoceles, but they can usually treat them with surgery.

It is best to see a doctor if any of the following symptoms accompany testicular pain:

• discoloration of the testicles
• nausea
• unusual, bloody or cloudy discharge from the penis
• testicular swelling
• vomiting
• pain that gets worse over time

Anyone with symptoms of testicular torsion should seek emergency medical attention. Without treatment, any condition that affects blood flow could result in loss of the testicle or surrounding parts.

If a person experiences swelling or pain in one or both testicles, it is best to see a doctor. If the pain is causing nausea and vomiting, they should seek immediate medical attention.

In cases of testicular torsion, the sooner a person seeks help, the more likely they can receive prompt attention to restore blood flow.

Medical treatments are available for most causes of testicular pain.

Testicle Pain Cause and Treatment

Some men may be reluctant to talk about it, but it’s quite common to have pain in your testicles or scrotum at some point in your life. It’s why many men see a urologist. Called orchialgia, long-term testicle pain can occur in men of any age, from adolescents to the elderly. It can affect one testicle or both, and the pain, which can range from mild and dull to severe and debilitating, may move toward the groin or abdomen. Causes range from trauma to inflammation to more serious concerns, and many cases occur for unknown reasons.

Illustration by Alexandra Gordon, Verywell

Causes

Though many things can give way to this kind of discomfort, experts suspect that the cause of chronic testicle pain is unknown in up to 50% of men. Known as chronic orchialgia, intermittent or constant testicle pain that lasts for three months or longer and is disruptive to daily life is diagnosed after other causes are ruled out. Doctors often suspect such pain is owed to irritated nerves, a pulled groin muscle, or pelvic floor spasms. Sometimes testing can identify the cause, but in some cases, the root cause cannot be confirmed.

Cases for which a cause is able to be identified are usually due to the following.

Common Causes

Testicle pain is often seen in men with these concerns.

Epididymitis

Epididymitis refers to inflammation of the epididymis, a duct located at the back of the testes. Along with testicular pain, epididymitis causes swelling and in severe, rare cases, a fever and chills. Most of the time, epididymitis results from a urinary tract infection or sexually transmitted disease, but it can also occur as a result of trauma or an autoimmune condition.

Trauma

Trauma to the testicle is usually mild, does not result in severe injury, and occurs from a direct blow to the testicle or from a straddle injury.

An Inguinal Hernia

Testicle pain may occur when a part of your intestines protrudes (herniates) into the scrotum with the testicles. An inguinal hernia may only be visualized as a groin bulge when a person coughs or lifts something heavy and can be confirmed on physical exam or by imaging.

Post-Vasectomy

After a vasectomy, a person may notice firmness within the epididymis (called congestive epididymitis) or a painful nodule called a sperm granuloma, which represents sperm leakage in the testicle. Both conditions can cause discomfort. Nerve entrapment after a vasectomy surgery may also cause testicle pain. In rare cases, post-vasectomy pain syndrome can occur.

Acute Idiopathic Scrotal Edema

Some men develop painless swelling only of the scrotum with no known cause or other symptoms due to lack of ambulation or other fluid status issues in body (such as congestive heart failure). This condition usually resolves on its own within two to three days of conservative care, like scrotal elevation and taking an anti-inflammatory medication.

Testicular Torsion

Testicular torsion is a surgical emergency that results from twisting of the spermatic cord, the structure that carries nerves to the testicles. It results in the sudden onset of one-sided, severe testicular pain and swelling, along with nausea and vomiting. While testicular torsion is more common in infants and pubescent boys, it can occur at any age.

Rare Causes

Luckily, the more serious causes of testicle pain are rare. They do, however, highlight the importance of listening to your body and seeking the advice of a doctor.

Tumor

Most testicular cancers do not cause pain, but rather present as painless nodules or lumps. However, some rapidly growing tumors may bleed or cut off blood flow to the testicle, both of which can lead to testicle pain.

Fournier’s Gangrene

Fournier’s gangrene is a severe bacterial infection that begins on the abdominal wall, spreads to the scrotum and penis, and causes gangrene (death of tissue). It is a rare, but potentially life-threatening cause of scrotal pain and swelling.

Other symptoms may include skin blisters, crepitus (a crackling or popping sensation), and symptoms of septic shock like a fever, high heart rate, and low blood pressure. The most common risk factor for developing Fournier’s gangrene is diabetes mellitus.

Fournier gangrene.

DermNet / CC BY-NC-ND

Diagnosis

Diagnosing the root cause of your testicle pain is the first step to getting better and feeling well. Your doctor will do a physical exam and recommend tests, as necessary.

Physical Examination

During the physical exam, your doctor will examine and then press on the testicles to check for swelling, tenderness, skin changes, and lumps or masses. He may also perform an abdominal exam and check for enlarged lymph nodes in the groin.

Labs and Tests

In order to rule out infection, like epididymitis, your doctor will order a urine culture, as well as a urethral swab (or urine test) to screen for sexually transmitted infections such as chlamydia and gonorrhea. If a tumor is suspected, blood tests that check for the tumor markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) may be ordered.

Imaging

The hallmark imaging test for examining testicle pain is a scrotal ultrasound, which can detect abnormalities like testicular cancer. With testicular torsion, a color Doppler ultrasound reveals decreased or absent blood flow to the testicle.  

Other imaging tests, like a computed tomography (CT) scan or magnetic resonance imaging (MRI), will be used for staging if testicular cancer is diagnosed. In cases where back issues may contribute to testis pain, back imaging may be obtained.

Differential Diagnoses

Not all pain in the testicular area actually comes from the testicle. In fact, referred pain, or pain radiating from somewhere else, such as from a kidney stone that has migrated and become stuck in the lower ureter (the tube draining the kidney) or a pinched nerve, may be the cause.

If your doctor suspects a kidney stone, a urine test to look for blood and/or a CT scan to evaluate your urinary tract system may be ordered. Likewise, imaging, often an MRI of your spine, and a thorough neurological exam can be used to diagnose a pinched nerve.

Treatment

Depending on the cause of your testicle pain, your doctor will recommend one of many therapies.

At-Home Treatments

Many causes of testicle pain can be treated or partially treated with at-home therapies. For instance, in addition to prescribed antibiotics, epididymitis can be treated with scrotal elevation, ice, and a nonsteroidal anti-inflammatory like ibuprofen to reduce pain.

For men with unexplained orchialgia, these options may bring relief, although beware that it may take three months or more for you to notice an improvement:

• Rest: Don’t lift heavy objects or do strenuous exercise. Avoid aggravating sore muscles.
• Heat: Using a heating pad or sitting in a hot bath can stimulate blood flow and soothe muscle aches.
• Anti-inflammatories: Nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen can reduce pain.
• Tight-fitting underwear: Wearing it helps restrain movement and the pain it can cause.
• Physical Therapy: Home exercises and stretching may help strengthen pelvic floor muscles and ease spasms.

Medications

Besides anti-inflammatory medications, antibiotics are used to treat infectious-related causes of testicle pain, such as epididymitis or Fournier’s gangrene.

Surgery

With certain causes of testicle pain, surgery is required. For example, Fournier’s gangrene requires emergent surgical removal of the infected and dying tissue, as well as sometimes reconstructive surgery. Likewise, testicular torsion requires emergent surgery to promptly restore blood supply to the affected testicle.

Surgery (radical orchiectomy) is also the first treatment for almost all testicular cancers.

Nerve Block and Cord Dennervation

A nerve block may be used for chronic orchialgia when at-home treatments don’t work.

With a nerve block, a urologist injects an anesthetic into the spermatic cord. If the anesthetic does take away the pain, your urologist can deduce that the cause of pain is in the testicle.

A urologist may then suggest a procedure called cord denervation, in which a urologist cuts nerves to the testicle. Specifically, microsurgical spermatic cord denervation (where nerves are ablated in spermatic cord) has been shown to be beneficial in some types of orchialgia. This is done in an outpatient surgical center and permanently relieves testicle pain in about 75% of men.

Note that if the initial nerve block does not relieve the pain, your urologist will likely refer you to a pain management specialist to further access the origin of the pain.

A Word From Verywell

Testicle pain isn’t widely discussed—even by urologists—and this is especially true when it comes to chronic orchialgia, in which the “why” behind a man’s pain is not always clear.

Rest assured, though, in the vast majority of cases, testicle pain can be treated. Be open to discussing your concerns with your doctor, and of course, seek immediate medical attention for any sudden and severe testicle pain.

Dr. Shoskes is a urologist at Cleveland Clinic Glickman Urological & Kidney Institute and is Director of the institute’s Novick Center for Clinical and Translational Research.

Testicular lumps and swellings | NHS inform

Treatment for your testicular lump or swelling will depend on the underlying cause.  Some lumps may not need to be treated at all if they are not causing any problems.

Treating varicoceles

In most cases, varicoceles do not require treatment. They usually don’t cause other symptoms or long-term problems.

Although varicoceles are sometimes associated with infertility, most men’s fertility is not affected and there is currently not enough evidence to suggest that treating varicoceles will help improve your chances of fathering a child.

If you have a varicocele that is causing pain or discomfort, taking simple painkillers such as paracetamol and wearing supportive underwear may help initially.

Your GP can refer you to a urologist (a doctor specialising in conditions affecting the urinary system) who can discuss the option of surgery with you if your varicocele is still causing your problems.

Surgery

In many cases, a technique called varicocele embolisation can be used to treat problematic varicoceles.

A tiny tube is inserted into a vein in your groin or neck and X-ray equipment is used to guide it to the affected veins in your testicles. Metal coils or a special liquid are then passed through the tube to block the affected veins. The blood will then bypass the blocked veins, reducing the swelling associated with the varicocele.

Most varicocele embolisation procedures are carried out on an outpatient basis, which means you will not have to stay in hospital overnight. It is usually carried out under local anaesthetic (you’ll be awake during the procedure but the affected area will be numbed). 

Varicocele embolisation is a safe and effective procedure, although you may experience some swelling or bruising where the tube was inserted for a few days afterwards. There is also a small risk of infection, which can be treated with antibiotics, and there is a possibility the varicocele could recur later on.

Some varicoceles need surgery to directly tie off or remove the affected veins. This is usually performed under general anaesthetic (where you’re asleep) and involves making incisions (cuts) in your groin or abdomen.

Treating hydroceles

Hydroceles in newborn babies usually disappear by the time the baby reaches two years of age. Treatment is usually only needed if they persist for longer than this, or cause pain or discomfort.

Treatment may also be recommended in boys or adults with a hydrocele that is particularly large or is causing any other symptoms. In such cases, you can be referred to a surgeon to discuss your options.

Surgery

A surgical procedure known as a hydrocelectomy is often recommended for hydroceles.  

In children, an incision is made in the groin before sealing the passage between the abdomen (tummy) and the scrotum that allows fluid to flow into the scrotum. In adults, the incision is made in the scrotum, the fluid is drained away and the incision is closed using dissolvable stitches.

Both procedures are usually carried out under general anaesthetic and most people will be able to return home soon after having the operation.

You may experience some discomfort, swelling, and fluid seepage from the wound after the procedure, but this should only last for a few days. Taking simple painkillers and wearing supportive underwear may help reduce any discomfort in the meantime.

As with a varicocele embolisation, there is a small risk of infection after a hydrocelectomy and there is a possibility the hydrocele could recur.

Treating epididymal cysts

Epididymal cysts don’t normally require treatment because they are usually harmless and don’t cause other symptoms. However, if you have a cyst that is getting bigger or is causing any pain or discomfort, you may be referred to a urologist to discuss the possibility of surgery.

Surgery

A procedure to remove an epididymal cyst is carried out under general anaesthetic and involves removing the cysts through a small incision in your scrotum that is sealed with dissolvable stitches.

In some cases, it may also be necessary to remove the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm) to prevent another cyst from forming.

As with other procedures, you may experience some discomfort, swelling, and fluid seepage from the wound for a few days after the procedure, but this should only last for a few days.  Taking simple painkillers and wearing supportive underwear may help reduce any discomfort.

There is also a small risk of the wound becoming infected and there is a chance of cysts recurring if the epididymis is not removed.

Treating epididymo-orchitis

As epididymo-orchitis is often thought to be caused by bacterial infections, such as sexually transmitted infections (STIs) and urinary tract infections (UTIs), treatment will usually involve a 10-14 day course of antibiotic tablets.

If your GP suspects epididymo-orchitis has occurred as a complication of a mumps infection, antibiotics are not used because mumps is caused by a virus.

In these cases, the swelling and pain in the testicles will usually resolve within a week or two. Wearing supportive underwear, applying cold or warm compresses to your testicles and taking simple painkillers may help reduce discomfort in the meantime.

Treating inguinal hernias

You may be referred to a surgeon to discuss the option of having an operation to push the bulge back into place and strengthen the weakness in the abdominal wall.

This operation will be carried out urgently if there are signs that the blood supply to the tissue forming the lump has become interrupted (strangulated), because this can cause the affected tissue to die.

There are two ways that an inguinal hernia repair can be performed:

• open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
• keyhole (laparoscopic) surgery – a less invasive but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience. With both types of surgery, you should be able to go home the same day or the day after.

An inguinal hernia repair is a routine operation with very few risks. Although it is not uncommon for a hernia to recur at some point after surgery.

Treating testicular torsion

If you have testicular torsion, you will need surgery as soon as possible to untwist the testicle. Permanent injury to the testicle can occur within hours of having testicular torsion, which may affect your fertility or result in the loss of your testicle.

Surgery for testicular torsion is carried out under general anaesthetic. The surgeon will make an incision in your scrotum before untwisting the spermatic cord (the cord that supplies the testicles with blood). The testicle (or testicles) will then be stitched to the inside of the scrotum to prevent the spermatic cord twisting again.

The longer you wait before having surgery, the higher the risk that your surgeon will not be able to save the trapped testicle. Research has found that when men have surgery within six hours of testicular torsion occurring, nine out of 10 twisted testicles will be saved. However, if the surgery is delayed for 24 hours, only one out of 10 twisted testicles will be saved.

If it is not possible to save the affected testicle, the surgeon will need to remove it and seal the spermatic cord. In these cases, another operation can be carried out at a later date to fit a replacement artificial (prosthetic) testicle.

Treating testicular cancer 

If you have been diagnosed with testicular cancer, you will be cared for by a team of clinicians, who will help decide the best treatment for you.

This will depend on factors such as the specific type of testicular cancer you have and how far it had spread before it was diagnosed.

Surgery to remove the affected testicle will be recommended in most cases and this may sometimes be followed by a course of chemotherapy or radiotherapy.

If you want, you can have a prosthetic testicle inserted into your scrotum so that the appearance of your testicles is not greatly affected.

In rare cases where it is necessary to remove both testicles, you will become infertile. However, you may be able to bank your sperm before the operation to allow you to father children in the future.

Read more about treating testicular cancer

Testicular Pain – an overview

Testicular or Scrotal Pain

Testicular and scrotal pain can suggest testicular torsion, epididymitis, orchitis, local abscess, Fournier’s gangrene, hernia, hydrocele, varicocele, and malignancy. Among these, testicular torsion, Fournier’s gangrene, and incarcerated hernia are surgical emergencies. When these diagnoses are clinically suspected, immediate surgical or urologic consultation should be obtained, before or concurrent with imaging studies.

Testicular torsion is best evaluated with either ultrasound (Figure 12-25, normal ultrasound) (Figures 12-26 and 12-27, testicular torsion) or nuclear scintigraphy. Physical examination is relatively unreliable, with significant overlap in findings such as cremasteric reflex abnormalities between patients with torsion and epididymitis.¹² Ultrasound is moderately sensitive and highly specific for persistent torsion (nearly 100% sensitive and specific in some studies,^13-14 though others report sensitivity of only 60% to 80% and specificity of only 80% to 90%^15-19). Intermittent torsion may be one explanation for negative ultrasound results. Delayed presentations of torsion beyond 8 hours have been reported to lead to false-negative ultrasound interpretations.²⁰ Decreased blood flow demonstrated by Doppler ultrasound suggests or confirms torsion, whereas normal blood flow is reassuring. Complete loss of blood flow may not occur. Venous flow is often compromised first, followed by arterial flow. Emergency physician–performed ultrasound shows high agreement with studies performed by sonographers and interpreted by radiologists—reported as 95% sensitive and 94% specific in one study, though wide confidence intervals in this study may mean lower true sensitivity and specificity.²¹ Nuclear scintigraphy detects abnormal testicular perfusion and has a sensitivity and specificity similar to that of ultrasound in studies directly comparing the two modalities, around 80% sensitive and 90% specific.^16,22 As stated earlier, consult a urologist as soon as torsion is suspected, before imaging. Because false-negative imaging results are possible, when torsion is strongly suspected clinically, surgery may be appropriate despite normal ultrasound or scintigraphy.

Epididymitis and orchitis (Figures 12-28 to 12-30) can be diagnosed by ultrasound. The usual indication for imaging is to rule out the diagnosis of testicular torsion. Increased Doppler blood flow signal in the epididymis or testicle suggests epididymitis or orchitis, respectively. The sensitivity and specificity are not well delineated, so other clinical factors should be incorporated into treatment decisions, rather than relying exclusively on imaging findings. Nuclear scintigraphy can also suggest increased blood flow consistent with epididymitis or orchitis.

Ultrasound of the scrotum can demonstrate loculated fluid collections consistent with abscess (Figures 12-31 to 12-33), although other fluids such as blood can have a similar appearance. Air in the scrotum from necrotizing infection causes dispersion of the ultrasound beam, disrupting the ultrasound image. Although this prevents a high-quality image, it can be diagnostic because air should never be found in the normal scrotum. As outlined earlier, Fournier’s gangrene and local abscesses of the scrotum can be identified by CT without IV contrast. Air, fluid, and inflammatory soft-tissue stranding are evident without contrast. IV contrast improves diagnostic sensitivity and specificity by demonstrating rim enhancement of abscesses. Rectal contrast can delineate abscesses adjacent to the distal bowel, which may otherwise be difficult to distinguish from fluid-filled bowel.

Hydrocele (Figure 12-34), or fluid within the scrotum and outside of the testicle, is readily diagnosed by ultrasound. Because hydrocele can accompany a variety of other conditions, including infection, testicular torsion, and malignancy, its presence should not be used to exclude other diagnoses. Hydrocele can be simple fluid elaborated from an adjacent inflammatory process or communicating with abdominal ascites. Loculated or heterogeneous hydrocele can suggest infection or organizing hematoma, so the differential diagnosis should be considered carefully. Isolated hydrocele with otherwise normal imaging findings, including normal testicular blood flow, may not require additional emergency imaging, with the caveat that hydrocele can accompany both harmless and concerning conditions such as testicular torsion. Spermatocele (Figure 12-35) has a similar ultrasound appearance. CT without IV or oral contrast can also demonstrate hydrocele, although it generally should not be ordered for this indication because ultrasound conveys the same information without radiation exposure.

Varicocele (Figure 12-36) is a benign venous abnormality characterized by a palpable mass on examination, often described as a “bag of worms.” Some patients may present with associated pain, usually not severe. Ultrasound readily confirms the diagnosis, demonstrating a series of low-flow channels using Doppler. Ultrasound is usually ordered to evaluate for other, more dangerous conditions, such as testicular torsion. CT can demonstrate this finding but is not generally indicated for its evaluation.

Malignancy can result in testicular or scrotal pain. Ultrasound can demonstrate solid testicular masses, which can include not only germ cell tumors but also metastatic and hematogenous malignancies such as lymphoma. Hydrocele may accompany these. CT may also demonstrate these abnormalities but is not the first-line imaging test because ultrasound provides accurate information without radiation. CT can be used to assess for metastatic involvement once an abnormality is confirmed with ultrasound.

Incarcerated hernia can be diagnosed using ultrasound and CT (see the chapter on imaging of nontraumatic abdominal conditions). Incarceration is largely a clinical diagnosis, based on pain, signs of bowel obstruction such as vomiting and absence of flatus, and inability to reduce the hernia on examination. However, both ultrasound and CT can confirm the presence of bowel within the scrotum. CT without IV contrast can demonstrate herniated bowel. Addition of IV contrast can illustrate bowel wall abnormalities such as abnormal enhancement suggesting ischemia. Oral contrast is rarely needed and not necessarily helpful because it may not reach the segment of herniated bowel. Ultrasound can demonstrate fluid- and air-filled bowel loops within the scrotum. Peristalsis may be visible, a reassuring finding suggesting preservation of bowel perfusion and viability. Air in the herniated bowel may scatter the ultrasound beam, disrupting the image. However, the presence of air in the scrotum is abnormal and can be recognized as suggestive of hernia.

90,000 Epididymitis | Directory of the Kuntsevo treatment and rehabilitation center

What is epididymitis

Among the inflammatory processes of the organs of the scrotum, the disease occurs most often and is characterized by inflammation of the epididymis. Pathology occurs in young people and adult men.

Types and causes of occurrence

The main factors in the development of inflammation of the epididymis is infection with complications after tuberculosis, sexually transmitted diseases. Slightly less often, epididymitis develops against the background of stagnation due to erections without sexual intercourse, masturbation, blood filling of the scrotum during interrupted intercourse.
The pathogen enters through the lymph or blood, along the vas deferens or urethra and can affect both one testicle or both at once. Basically, the pathology spreads on the left side.

Symptoms

Distinctive features of epididymitis of the epididymis are:

• pain in the groin of a pulling character. It radiates to the abdomen and lower back with light exertion and sharply increases with ejaculation, urination,
• testicle swells a little,
• there is an admixture of blood in urine and semen,
• there are complaints of premature ejaculation.

The clinical picture is complemented by signs of intoxication, while the density of the testicle remains the same.
Chronic epididymitis looks the same, but the symptoms are less pronounced.

Which doctor treats epididymitis

If you suspect inflammation of the epididymis, you should consult a urologist.
You can sign up for the treatment of epididymitis at any time on your own on the website or by phone. The administrator will tell you the next available date and time when the urologist will be ready to see you.Since the clinic in Kuntsevo is open from 8 am to 10 pm, there are no problems with the appointment.

Treatment methods

First of all, the doctor relies on the results of tests and examinations. If no purulent foci are found in the epididymis, then preference is given to conservative therapy. The course of antibiotics, antispasmodics, anti-inflammatory drugs, analgesics and vitamins is selected individually, based on a blood test. At the time of therapy, the urologist issues a sick leave so that the man respects bed rest.
Surgical intervention is prescribed as a last resort when chronic inflammation or suppuration is diagnosed.

Results

If the ultrasound does not reveal suppuration, then the mild and middle stage of inflammation is eliminated quickly. After a few days, the patient’s well-being improves, and after 2 weeks the signs of epididymitis completely disappear.

Rehabilitation and Lifestyle Restoration

After completing the course of treatment, the patient needs to make adjustments to his usual lifestyle.For example, it is necessary to give up interrupted sexual intercourse and masturbation in order to eliminate the risk of stagnation. You can not overcool and visit the steam room.
It is worth noting that any infectious disease can serve as an impetus for a relapse, so it is important to seek medical help from a doctor in a timely manner.

Why it is necessary to treat epididymitis with us

Treatment of epididymitis requires prompt medical attention. The question of where to cure epididymitis in Moscow does not arise, because the patients of the Kuntsevo treatment and rehabilitation center can consult with a urologist, get tested and receive a treatment regimen in just a few hours.Our clinic has the latest equipment and our own laboratory for accelerated diagnosis. Qualified doctors treat the problem of each man individually and prescribe not only therapeutic therapy, but also restorative measures.

The content of this article has been checked and confirmed for compliance with medical standards by urologist Lev Seyranovich Aleksanyan

Treatment of epididymitis (inflammation of the epididymis) in Kazan

It is important to start treatment of epididymitis in the first 5 days!

Within 5 days without treatment, the symptoms of inflammation begin to smooth out:

• painful sensations gradually weaken;
• Pain and discomfort recur periodically, but they are not so strong;
• the swelling decreases – gradually the patient gets used to the slightly enlarged testicle and perceives it as normal.

As a result, the patient comes to the conclusion that everything apparently went away on its own.

Remember! Acute inflammatory diseases (including epididymitis) do not go away by themselves . Relief of symptoms is a clear sign that the disease is becoming chronic. And chronic epididymitis can quickly lead to infertility.

We treat all types and forms of epididymitis

Epididymitis happens:

• unilateral or bilateral;
• acute or chronic;
• purulent or non-purulent;
• infectious (bacterial) or post-traumatic.

Epididymitis is often accompanied by orchitis (inflammation of the testicle), this form of the disease is commonly called “ orchiepididymitis or epididymoorchitis “.

How to define acute epididymitis?

Symptoms of acute epididymitis manifest themselves so clearly that their appearance cannot be overlooked:

• pain in the scrotum – when moving and / or at rest;
• pain radiating to the perineum, groin, less often to the lumbosacral region;
• edema and enlargement of the epididymis;
• redness of the skin of the scrotum;
• increase in body temperature;
• weakness, malaise.

The listed symptoms can persist for 5 days (the duration depends on the individual characteristics of the organism). It is very important to have time to start treatment during this period.

How do we treat acute epididymitis

First you need to relieve the inflammation. This is the first stage of treatment. The patient is selected for a course of pharmacotherapy (injections, droppers, tablets, ointments, suppositories, etc.).

Second stage – physiotherapy (magnetotherapy, therapeutic laser, ozone therapy, electrical stimulation, neurostimulation, etc.)P.).

The third stage is the development of preventive recommendations and, if necessary, dispensary observation by the attending urologist for a duration of 3 to 6 months.

How we treat chronic epididymitis

The treatment of chronic epididymal inflammation is more difficult and takes longer, for the following reasons:

1. A fairly large number of physiotherapy procedures are required.
2. In some men, against the background of epididymitis, other inflammatory diseases (orchitis, vesiculitis, prostatitis, urethritis, cystitis, etc.) may appear or recur.). In this case, it is recommended to treat these problems in parallel.

After the treatment of chronic epididymitis, it is necessary to systematically undergo additional examinations – ultrasound of the scrotum organs and analyzes. And strictly follow the recommendations of the urologist.

In advanced cases (if the patient has been living with a chronic process for a long time), a surgical operation may be required – removal of the epididymis.

Do not bring to the operation – see a doctor in time!

Epididymitis – diagnosis and treatment in the medical center “St. Andrew’s hospitals

Causes of epididymitis

Often epididymitis appears in chronic inflammatory diseases of the genitourinary system, such as urethritis, prostatitis, vesiculitis. Epididymitis can also appear after trauma to the scrotum, pelvis, perineum, as well as due to reasons affecting the stagnation of blood in the small pelvis, for example, due to prostatitis. This disease may also occur after sterilization, that is, after bandaging or removing the vas deferens. As a result, the sperm formed in the testicles do not have time to dissolve, they accumulate in the epididymis and then the inflammatory process begins.

Symptoms of epididymitis

The disease is characterized by an acute onset with the onset of pain in one part of the scrotum and an increase in its size.The pain spreads to the groin, to the perineal region, sometimes radiates to the lower back, and can sharply increase with movement. The scrotum is enlarged and smoothed due to edema. At the same time, an increase in body temperature up to 39C is noted, symptoms of inflammation such as weakness, loss of appetite and headache appear. The enlarged epididymis becomes denser, there is a sharp soreness when touched.

If there is no treatment for several days, then the inflammation of the epididymis will lead to its suppuration.In this case, the patient’s well-being worsens, the body temperature rises even higher, the skin of the scrotum begins to shine, sharp pain when touched. Also, inflammation can go to the testicle, that is, acute orchitis will occur. Overgrowth of connective tissue is possible, which makes the epididymis impassable for sperm. If the epididymitis is bilateral, then this can cause obstructive infertility.

Diagnosis of epididymitis

• Bacteriological urine culture and general urine analysis;
• Microscopy of urethral discharge;
• Clinical blood test;
• PCR and other immunological methods to determine the presence of bacteria that cause epididymitis;
• Radioisotope research;
• Doppler ultrasound of the scrotum to study blood flow velocity;
• Cystourethroscopy.

Epididymitis treatment

With a mild form of epididymitis, the patient can be treated at home, but observing strict bed rest. To ensure the immobility of the scrotum, it is given a fixed, elevated position. During treatment, you need to follow a diet that limits the use of spicy and fried foods. At the time of acute inflammation, cold can be applied by applying a cold compress to the scrotum with ice. The duration of the session is up to 2 hours, with a break of at least 30 minutes.

You also need to cure the disease that caused the development of epididymitis. Antibiotics, enzymes, and vitamins may be prescribed. The treatment is completed with thermal procedures for the scrotum, physiotherapy.

If suppuration of the epididymis occurs, then an operation is performed, an autopsy and drainage of the abscess is performed, rarely – removal of the epididymis.

Chronic epididymitis is characterized by persistent testicular pain, especially when walking.The body temperature rises regularly to 37C. The epididymis is dense and painful when felt. Chronic epididymitis more often than acute, occurs on both sides and more often causes obstructive infertility.

In chronic epididymitis, treatment is used the same as in acute, but longer, using physiotherapeutic procedures.

Prevention of epididymitis

Prevention consists in the treatment of chronic inflammatory diseases of the genitourinary organs, that is, chronic prostatitis and urethritis.If you suffer an infectious disease or receive an injury to the scrotum, be especially careful, and if you suspect the occurrence of epididymitis, immediately seek help from a urologist.

Effective treatment of epididymitis orchitis without abscess on DocDoc.ru

Urologists of Moscow – latest reviews

At the reception, the doctor made a mini examination and consulted.Now I am undergoing the tests that he prescribed for me. As a result, I received a tip on what I should be treated with now. The doctor is good, helpful, attentive. He helped me understand my problem, explained a lot. I was pleased with the quality of the reception.

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July 16, 2021

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He examined me, developed a plan for our further actions and informed me about the cost of treatment.He was polite to me and explained everything in an accessible way. The specialist seemed to me to be a professional! I selected it by the rating on the site.

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Show 10 reviews of 14,103 90,000 symptoms, treatment, diagnosis and prevention

A special type of epididymitis in men is considered to be inflammation that develops after vasectomy, removal or ligation of the vas deferens.

Symptoms of epididymitis

According to the form of the course, acute and chronic epididymitis are distinguished. The disease begins with the appearance of severe pain in one half of the scrotum. The pain syndrome can increase with movement, spread to the groin, perineum, give to the sacrum and lower back.

The characteristic symptoms of epididymitis are also:

• Temperature rise on the affected side to 39-40 ° C.
• Swelling, redness, enlargement of the scrotum.
• The appearance of blood in the semen.
• Swollen lymph nodes in the groin.
• Painful ejaculation.

Due to edema, the skin of the scrotum loses folds. At the same time, the patient develops general signs of an inflammatory disease: chills, weakness, headache, loss of appetite.

The epididymis enlarges, becomes dense, touching it responds with sharp pain. The vas deferens feels like a tight, painful cord.

What will happen if you do not receive treatment

In the absence of proper treatment, symptoms of acute epididymitis will subside after 3-5 days, but epididymal suppuration may begin. A similar phenomenon leads to a sharp deterioration in the patient’s condition, an increase in body temperature. The skin of the scrotum becomes smooth, glossy, and very painful.

Another complication of epididymitis in men threatens the transition of inflammation to the testicle, the development of acute orchitis. If the duration of the inflammatory process is more than 4-6 months, the disease turns into a chronic course, as a result of which fibrous degeneration of the epididymis is possible.The final is the obstruction of the epididymis for sperm and the inability of sperm to fertilize. Bilateral inflammation often causes obstructive infertility (see article “Male infertility”).

Treatment of acute epididymitis in men

In milder forms of epididymitis, patients are treated at home, hospitalization is carried out only when there is a likelihood of complications of the disease. A patient suffering from acute epididymitis is recommended strict bed rest.To ensure the immobility of the scrotum, it is given a fixed elevated position (using a rolled towel). For the period of treatment, it is necessary to adhere to a diet that excludes spicy and fried foods from consumption. During acute inflammation, local application of cold is necessary – a cold compress on the scrotum or ice (séance duration 1–2 hours, a break of at least 30 minutes).

To eliminate the symptoms of epididymitis, the patient is prescribed antibiotics, enzymes, absorbable drugs, vitamins.When the acute inflammatory process in the epididymis subsides, thermal procedures are applied to the scrotum, physiotherapy is prescribed.

With the development of suppuration of the epididymis, an operation is performed – opening and drainage of the abscess, in severe cases – removal of the epididymis.

How does chronic epididymitis manifest

In some cases, chronic inflammation of the epididymis can develop in specific inflammatory diseases (syphilis, tuberculosis) or after sterilization of a man.Symptoms of chronic epididymitis include persistent or recurrent testicular pain, especially when walking. Pain can also radiate to the groin, sacrum and lower back. Body temperature regularly rises to 37.2-37.3 ° C. The epididymis becomes hot and painful to the touch. Areas of compaction appear.

Chronic inflammation is more often than acute, it is bilateral and has a significantly higher probability of developing into bilateral obliteration of the epididymis and causing obstructive infertility.

Treatment of chronic epididymitis in men is fundamentally the same as for acute, but longer. The main focus is on local effects and the use of physiotherapy procedures. With ineffective conservative therapy and the development of complications, they resort to epididymectomy – the surgical removal of the epididymis.

Prevention

Measures for the prevention of inflammation of the epididymis are carried out in three directions:

• Prevention of sexually transmitted diseases by observing the rules of personal hygiene, using condoms during casual sexual intercourse.
• Immediate appeal to a urologist at the first signs of acute epididymitis, suspicion of urethritis or other diseases of the genitourinary system.
• Timely treatment of infectious diseases.

In other cases, you just need to listen carefully to your feelings, take good care of your health.

EPIDYDYMITIS

Epididymitis – the most common inflammatory disease of the genitourinary
systems in men.Epididymitis is characterized by inflammation of the epididymis.

Specialists of the Center of Urology and Andrology identify non-specific
epididymitis and specific epididymitis .

Clinical:

• Acute epididymitis
• Chronic epididymitis

By morphological characteristics:

• Serous epididymitis
• Purulent epididymitis
• Infiltrative epididymitis

With the course of the disease, in the process of inflammation of the epididymis, they may howl
the spermatic cord (funiculitis) and the vas deferens (deferentitis) are involved.

When self-medicated, epididymitis often leads to testicular inflammation with subsequent
male infertility.

Symptoms of epididymitis

Epididymitis is characterized by the following symptoms:

• Acute pain in the scrotum
• Acute pain in the groin area
• Enlargement of inguinal lymph nodes
• Pain during ejaculation

• Redness and swelling of the scrotum
• High body temperature
• Weakness and chills
• Headaches

Why see a doctor?

The manifestation of any symptom of epididymitis is a reason for referral to
Center of Urology and Andrology on Taganka.

Self-medication or neglect of epididymitis will inevitably lead to
the development of other diseases, the treatment of which may require
surgical intervention:

• Testicular suppuration
• Spread of the inflammatory process
• Fistula formation

Male infertility – the result of insufficient and unqualified treatment
bilateral epididymitis.

Timely contact with the Urology and Andrology Center guarantees a quick
cure epididymitis without the development of further complications!

Causes of epididymitis

Clinical studies carried out at the Center for Urology and Andrology at
Taganka identified the following causes of epididymitis:

• Sexually transmitted infections
• Viral mumps
• Insufficiently cured prostatitis
• Neglected urethritis
• Prostate adenoma

• Tuberculosis
• Mechanical trauma to the scrotum
• Inaccurate medical manipulations in the urethra
• Non-compliance with personal hygiene

Diagnosis of epididymitis

The Center of Urology and Andrology has developed a standard for the diagnosis of epididymitis, when
which eliminates the risk of “missing” this disease.Our specialists
carry out the following types of surveys:

• History taking and examination of the scrotum
• Blood tests
• Urinalysis (3-glass sample)
• Ultrasound of the scrotum
• Ultrasound of the prostate

• Ultrasound of the bladder
• Digital rectal examination
• Study of urological smear
• Bacteriological culture of urological smear

The more fully and comprehensively the survey is carried out, the more information
available to a specialist who, on their basis, will make the most effective
treatment plan.

The Center of Urology and Andrology on Taganka has everything you need for
diagnosis and treatment of epididymitis.

Treatment of epididymitis

To alleviate epididymitis syndromes and create a supportive environment
for treatment, our specialists recommend:

• Compliance with bed rest
• Use of special support pants (swimming trunks)
• Compliance with a diet with the exception of spicy and fried foods
• Drinking plenty of water

Based on the results of the tests and studies performed, the doctor
prescribe medication, including:

• Antibacterials
• Anti-inflammatory drugs
• Immunostimulating drugs
• Antipyretics

In case of purulent epididymitis, surgery is required to
removal of the epididymis.

For the successful treatment of epididymitis, it is important to extinguish the sources of infection in
other organs. This is possible only with complex treatment.

The multidisciplinary nature of the Urology and Andrology Center allows for
successful complex treatment in a single institution.

Benefits of treating epididymitis with us

The staff of the Center of Urology and Andrology on Taganka developed
numerous standards for the diagnosis and treatment of epididymitis. Since this
the disease is the most common inflammation of the genitourinary organs
systems in men, our specialists have accumulated a very large experience in treatment
of this disease.

All rooms of our clinic are equipped with modern diagnostic equipment
– Ultrasound, TRUS, etc. The clinic is equipped with its own X-ray
department and clinical laboratory.

Availability of everything necessary allows us to carry out diagnostics and treatment in
very tight deadlines.

For the purpose of comprehensive treatment, the Urology and Andrology Center is at your service
provides the services of specialists in various fields – therapists,
immunologists, proctologists, surgeons – in total, more than 120 specializations!

The Urology and Andrology Center guarantees its patients:

Complete anonymity of contacting the clinic

Express diagnostics of infections and bacteria

Reliability of test results

Removal of pain and inflammation on the day of treatment!

Trust your health to the epididymitis professionals – the Urology and
andrology!

Call and make an appointment, we will be happy to help you!

90,000 Testicular torsion in a child – causes, symptoms, diagnosis and treatment of acute scrotal syndrome in a child in Moscow at the children’s clinic “SM-Doctor”

Testicular torsion is abnormal twisting of the spermatic cord, which is caused by the rotation of the fold between the gonad and its epididymis. This acute condition is not uncommon. So, the development rate is 1: 500. Every fifth case occurs in the first 10 years of a boy’s life, and every second case – from 10 years to puberty.

Testicular torsion is an emergency pathology that occurs under the influence of various factors. Their role can be traumatic damage to the scrotum, a significant increase in intra-abdominal pressure and sudden movements, leading to a sudden contraction of the muscle that lifts the testicle (cremasteric muscle).In addition, some abnormalities in the development of the genital organs can lead to testicular torsion – in particular, cryptorchidism (non-descending of the gonad into the scrotum) and the lack of normal attachment of the gonad to the bottom of the scrotum. However, in some cases, torsion can occur at rest (during sleep).

There are 2 types of torsion – intravaginal and extravaginal. The first is the most common and occurs most often in children over 1 year of age. In this case, torsion of the spermatic cord is observed inside the vaginal membrane covering the testicle. In extravaginal twisting, twisting occurs outside the vaginal membrane. Usually this condition develops in utero or in the first month of life.

Complications

With testicular torsion, venous blood flow is first disturbed, and then arterial. If the spermatic cord is not promptly returned to the correct position, then the testicular tissues at the first stage experience ischemia (lack of oxygen and nutrients), and then their necrosis occurs, i.e. death due to lack of blood supply.In case of necrosis, the testicle must be removed, which can subsequently lead to impaired spermatogenesis and infertility. If the second testicle does not take over the function of the remote one, then the synthesis of testosterone, the main hormone of men, decreases. Therefore, it is so important, at the first symptoms of pain in the scrotum, its swelling and redness, to consult a child with a pediatric surgeon as soon as possible.

If blood circulation in the testicle is not restored in the near future, then irreversible pathological processes develop. According to most pediatric surgeons, testicular tissue death occurs after 6-12 hours, depending on the degree of volvulus. A twisted, non-viable testicle can lead to septic complications that pose a direct threat to life.

Symptoms

Symptoms of testicular torsion depend on the age of the child. In newborns, clinical manifestations appear only a few hours after the twisting of the spermatic cord. Babies become restless due to pain in the scrotum, body temperature rises, vomiting or regurgitation may join.

In older children, from the first minutes, the disease is characterized by a vivid clinical picture. The child is worried about intense groin pain, which in some cases may be associated with injury or a fall, and in others it will appear for no apparent reason. The pain radiates to the groin area, may radiate to the lower abdomen with the side corresponding to the testicular torsion. The general state of health worsens, there is a sharp pallor of the skin, cold sweat, nausea, vomiting may occur. The appearance of the scrotum changes – it becomes edematous and acquires a bluish color from the side of the lesion, the twisted testicle rises upward. These symptoms are soon joined by a rise in body temperature.

Symptoms vary in patients with cryptorchidism. If the testicle is in the abdominal cavity, then the child suddenly has acute abdominal pain, while there are no changes in the groin area and in the scrotum. When the testicles are located in the groin area, sudden restlessness and vomiting appear, older children note pain along the inguinal canal and nausea.In the groin, a sharply painful formation of a dense consistency is determined, the skin over which is swollen and red.

In some cases, in the presence of signs of torsion of a normally located testicle, the symptomatology may independently regress.

After a while, these symptoms reappear. This condition is called “intermittent” testicular torsion. In this case, surgical intervention is required to fix the testicle in the correct position. If untreated, the risk of significant torsion and subsequent death of the gonad increases.

Diagnostics

The child must be shown to a pediatric surgeon within the first 2 hours after the onset of pain. The protractor must be carried out in a horizontal position.

Objective diagnostic data are often very informative. When examining the scrotum in favor of testicular torsion, the following symptoms speak:

• The mobility of the twisted testicle is limited;
• the affected testicle is elevated, its longitudinal axis can be displaced to the side;
• attempts to raise the testicle are accompanied by increased pain;
• there is no cremasteric reflex, which consists in the fact that when the skin of the inner thigh is irritated, the testicle is raised due to the contraction of the corresponding muscle;
• edema and hyperemia.

To establish the final diagnosis and assess blood flow in the spermatic cord, ultrasound scanning of the scrotum organs and Doppler ultrasonography of the supplying vessels are performed. Ultrasound allows for differential diagnosis between pathologies that have similar symptoms, namely torsion and epididymitis (inflammation of the testicular epididymis).

Treatment

After the diagnosis is established, an emergency scrototomy is performed – dissection of the membranes of the scrotum for the purpose of revision of organs.Before the child is admitted to the operating room, during the initial examination, it is possible to perform manual detorsion (unwinding of the testicle during palpation), this technique helps to relieve pain, improve microcirculation until the moment of surgical treatment. The pediatric surgeon carefully examines the testicle, epididymis, hydatids, spermatic cord and scrotal membranes. Then, gently, without injuring the tissue, it unfolds the twisted gonad and assesses its viability.

Thermal application is carried out with warm physiological or antiseptic non-alcoholic solutions.Hydatids (affected and unaffected) are removed, the scrotal cavity is sanitized. If 24 hours or more have passed since the onset of acute pain, a consultation of 3 doctors is convened to assess the viability of a twisted testicle. Removal of the organ is carried out only if there is no chance of saving the gonad. The operation, regardless of the volume, ends with a cosmetic suture or drainage.

The novocaine blockade of the spermatic cord elements is also performed.

The duration of the surgical procedure ranges from 15 minutes to 1.5 hours.

In the absence of complications (with timely access to medical help), the child spends up to 2 days in the hospital. In the presence of complications, the average length of stay is 1 week.

After discharge, the child must spend 7 days at home, come to the clinic for dressings, receive medical rehabilitation therapy and limit physical activity for up to 2 months.

Treatment result

Timely treatment of testicular torsion can completely normalize blood flow on the affected side and save the gonad from necrosis. This guarantees a normal quality of life and an adequate level of testosterone synthesis in an adult man who experienced torsion in childhood.

To a large extent, the success of treatment depends on the time of seeking specialized medical care. According to statistics, during the operation within the first 6 hours after the onset of pain, the preservation of testicular viability approaches 100%. If the operation is performed after 12 hours, then the chances of preserving the gonad are only 20%.When performing a surgical intervention after one day, there is practically no chance to save the organ.

“SM-Doctor” is a round-the-clock clinic that specializes in providing medical care of any degree of complexity to children from birth to adulthood. Our center works 24/7. Pediatric surgeons have all the technical capabilities to carry out the most accurate and fast diagnosis and immediate treatment of the identified pathology.

When the first suspicious symptoms of poor health of a child appear, do not risk his health, but immediately contact a professional!

You can make an appointment or ask questions around the clock by phone +7 (495) 292-59-86

.