Epididymitis Symptoms, Types, Causes, Treatment, and Prevention

What Causes Epididymitis? What are its Underlying Symptoms, Types, Treatment options and Preventions?

Epididymitis is a painful inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. It can affect men of any age, even though it is rare among older men.

Although the syndrome is usually treatable, understanding the various forms is essential to ensure early and appropriate management. Read ahead to understand the different kinds of epididymitis, what leads to it, what symptoms may arise, and how to treat it.

What are the Types of Epididymitis?

Understanding the forms of epididymitis helps distinguish the underlying cause and guide effective treatment. Listed below are the 4 types of Epididymitis:

1. Acute Epididymitis

This form is acute and usually brief, rarely more than six weeks. It is frequently the result of a bacterial infection, primarily sexually transmitted infections (STIs) such as chlamydia or gonorrhea in younger men. In older men, it is usually associated with a urinary tract infection or prostate problems.

2. Chronic Epididymitis

This type lasts more than six weeks and can occur gradually. Unlike an acute infection, which is mainly caused by bacteria, the cause of chronic epididymitis is not always clear. It can be characterized by inflammation due to previous injury, autoimmune conditions, or incomplete treatment of a past infection.

3. Non-Infectious Epididymitis

Non-infectious causes may include physical injury, heavy lifting, prolonged sitting (eg, cycling), or backwards urine flow into the epididymis. This is less common, but it is essential to distinguish this from infectious types to provide appropriate treatment for epididymitis.

4. Tuberculous Epididymitis

This form is unusual and occurs when tubercle bacilli reach the genital tract. It is common in high TB-prevalent areas and should be treated with specific antibiotics for successful treatment.

What are the Symtoms of Epididymitis?

Identifying early symptoms is key to prompt care. Some of the most common epididymitis symptoms include:

• Sudden or gradual scrotal pain
• Swelling and redness of the scrotum
• Painful urination
• Frequent or urgent urination
• Fever and chills
• Discharge from the penis (in STI-related cases)
• Blood in semen

If the testicle also becomes inflamed, the condition is termed epididymo-orchitis, which may indicate a more advanced stage.

What are the Causes of Epididymitis?

Different causes contribute to the condition, depending on an individual's age and health background. A few of the common causes include:

• Sexually Transmitted Infections:Chlamydia and gonorrhea are leading causes in younger, sexually active men.
• Urinary Tract Infections: Often seen in older men or those with prostate enlargement.
• Instrumentation:Catheters or urological procedures can introduce bacteria.
• Trauma:Injury or physical strain can lead to non-infectious inflammation.
• Chemical Epididymitis:Due to urine reflux into the epididymis.

What is Acute Epididymo-Orchitis? 

Acute epididymo-orchitis is a severe variant of epididymitis. It occurs when inflammation extends from the epididymis to the testicle. This can be extremely painful and has a higher chance of complications like damage to a testicle or abscesses. Rapid treatment of epididymitis, sometimes involving antibiotics for orchitis treatment, is necessary in these cases.

What are the Epididymitis Treatments and Medications?

Epididymitis treatment typically depends on the underlying cause and severity. Some of them are as follows:

1. Antibiotics : Antibiotic therapy is the cornerstone of infectious epididymitis treatment. For STI-related infections, a combination of ceftriaxone and doxycycline is often prescribed. In urinary tract-related cases, fluoroquinolones such as levofloxacin may be used. It is strictly advised always to complete the full course of epididymitis medication, even if symptoms improve early.
2. Pain Management : NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen help alleviate pain and inflammation. Bed rest, scrotal elevation, and ice packs are supportive measures.
3. Surgery : In rare cases of chronic or recurrent epididymitis that don't respond to medication, surgical removal of the epididymis (epididymectomy) may be considered.
4. Treating Sexual Partners : For STI-related cases, it is essential to treat sexual partners to prevent reinfection.

What is the Orchitis Treatment?

The treatment strategy is more intensive when epididymitis progresses to involve testicular inflammation (epididymo-orchitis). Orchitis treatment involves higher or prolonged doses of antibiotics, especially if there is bacterial involvement. Antibiotics are not valuable for viral cases, like mumps orchitis, and supportive care is recommended.

What are the Preventive Measures for Epididymitis?

While not all types of epididymitis are preventable, the risk can be reduced by the following practices:

• Practice safe sexual intercourse (condoms, STI testing)
• Avoid heavy lifting or straining
• Treat urinary infections promptly
• Limit the use of catheters and urological procedures unless necessary

With timely and proper epididymitis treatment, most individuals recover fully without complications. Chronic forms may require long-term management and follow-up. Thus, it is wise to have health insurance to safeguard your health and finances during critical times.

At Star Health, we offer coverage for Epididymitis under our health insurance policies. We also provide hassle-free claim settlements with reduced turnaround time across over 14,000 network hospitals in India.