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Epididymitis

Intro

Mild scrotal pain, urinary  symptoms, or any of the other symptoms of epididymitis suggest a visit to your health care provider because the treatment for epididymitis is an antibiotic. If the doctor is concerned about complications or an alternative diagnosis, you will likely be sent to a hospital for further tests. If you have scrotal pain or urinary symptoms and cannot be seen by your health care provider (or if you do not have one), then you should go to a hospital's emergency department. Symptoms that require urgent care include these:

Severe scrotal pain: This could represent testicular torsion, which is a very serious disease that needs immediate attention. The outcome for this particular diagnosis is time dependent. The faster you get treatment, the less damage may be done. Seek care immediately.

  • Urinary symptoms
  • Discharge from your penis
  • Pain or burning with urination
  • Urinary frequency (more often than normal)
  • fever and chills
  • Nausea
  • Abdominal  or flank pain
Follow-up

Follow up with your health care provider to ensure that the antibiotics are working.

  • If you are not responding to antibiotics, you may need an ultrasound (ordered by the doctor or urologist, who is a specialist in genital conditions). This is an imaging procedure to check your genital area.
  • Make sure your condition doesn't progress to become orchitis , an infection of the tube that carries semen out of 1 or both testicles. This is called epididymo-orchitis. Orchitis can result from the spread of bacteria through the blood from other locations in your body.
  • A testicular tumor may be present. An ultrasound or blood test might be needed.

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Prevention

For men younger than 35 years, the cause is usually sexually related disease. If one partner is infected, the other partner should be evaluated and potentially treated as well. Otherwise, you may become reinfected.

  • Abstinence (no sexual relations)
  • Condom use
  • Single partner

For men older than 35 years, good hygiene is suggested for those who are uncircumcised.

Outlook

If treated appropriately with antibiotics, your infection should clear up.

  • Pain improves within 1-3 days.
  • Swelling may take several weeks to go away.
  • Complications are possible.
  • Sterility: If the epididymitis involves both sides and is untreated, sterility may result (rarely, sterility can still occur even with antibiotic treatment).
  • Scrotal abscess (an infection)
  • Co-infection of the testicle (epididymo-orchitis)
  • Sepsis (spread of infection into the bloodstream
  • Fournier gangrene (a severe and life-threatening infection of the scrotal area that kills the cells)

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