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What is epididymitis?
Epididymitis is an inflammation of the epididymis. The epididymis is a tube located at the back of the testicles that stores and carries sperm. When this tube becomes swollen, it can cause pain and swell in the testicles.
Epididymitis can affect men of all ages, but it’s most common in men between ages 14 and 35. It’s usually caused by a bacterial infection or a sexually transmitted disease (STD). The condition usually improves with antibiotics.
Acute epididymitis lasts six weeks or less. In most cases of acute epididymitis, the testes are also inflamed. This condition is called epididymo-orchitis. It can be difficult to tell whether the testes, epididymis, or both are inflamed. That’s why the term epididymo-orchitis is commonly used. According to the Centers for Disease Control and Prevention (CDC) Trusted Source, gonorrhea and chlamydia are the most common causes in men 35 years old or younger
Chronic epididymitis, on the other hand, lasts six weeks or more. Symptoms include discomfort or pain in the scrotum, epididymis, or the testicles. This may be caused by granulomatous reactions, which can result in cysts or calcifications.
Pathophysiology of epididymitis
The pathophysiology of epididymitis is divided; Chlamydia trachomatis and Neisseria gonorrhoeae are the most common pathogens in patients younger than 35 years, whereas Enterobacteriaceae and gram-positive cocci are frequent pathogens in older patients. In either case, infection results from a retrograde ascent of infected urine from the prostatic urethra into the vas deferens and, finally, into the epididymis.
Causes of epididymitis
The spread of bacterial infection usually causes epididymitis. This infection will often start in the urethra, prostate, or bladder.
Two main types of infection cause epididymitis:
Sexually transmitted infection (STI)
Epididymitis caused by an STI, such as gonorrhea or chlamydia, is most common in young, heterosexual men; particularly those who have sex with multiple partners and do not use a condom.
Cases of epididymitis that are not caused by an STI are less common.
Urinary tract infection (UTI)
Epididymitis caused by a UTI occurs in children, older men, and men who have sex with men. The following factors often cause UTIs in men:
- Enlarged prostate pressing on the bladder
- Insertion of a catheter into the penis
- Surgery on the groin, bladder, or prostate gland
Children
While cases of epididymitis in children are rare, they do occur. Often the bacterial infection will spread from the urethra or bladder.
Inflammation will usually develop due to one of the following:
- Direct injury to the area
- Twisting of the epididymis
- Urine flowing back into the epididymis
Other causes
There are also some more unusual causes of epididymitis:
- Mumps
- Tuberculosis
- High doses of a medication called amiodarone, usually taken for heart rhythm problems
- Groin injury
- Structural problems in the urinary tract
- Behcet&
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