Epididymitis is an inflammation of the epididymis which is generally caused by a bacterial infection and is characterized by swelling of the testicles. This condition can occur in men of any age. but most often in the 19–35 year age group.
The epididymis is the tube that connects the testes to the vas deferens, the duct will carry sperm to the penis. The function of the epididymis is as a place for sperm maturation. In addition, the epididymis can also contract to push sperm out during ejaculation.
When epididymitis occurs, inflammation causes swelling and pain in the epididymis. This condition usually gets better with antibiotics. However, if treated too late, the inflammation can spread to the testicles.epididymo-orchitis).
Causes of Epididymitis
Epididymitis can be caused by infectious or non-infectious diseases. Here is the explanation:
Infectious disease
Types of infectious diseases that cause epididymitis include:
- Sexually transmitted infections, such as chlamydia and gonorrhea
- Viral infections, for example Adenovirus, Enterovirus, and Influenza
- Bacterial infection Escherichia coli (E. coli)
- Opportunistic infections, such as cryptococcus and cytomegalovirus in people with HIV
- TB (tuberculosis)
- Mumps
Non-infectious disease
Although generally caused by infection, epididymitis can also be caused by non-infectious diseases, such as:
- Enlargement of the prostate
- Urinary reflux, which is a condition when urine flows into the epididymis which generally occurs due to overstretching the body or lifting heavy objects
- Testicular torsion
- Injuries in the groin area
- Behçet . disease
- Complications of genital surgery, eg vasectomy
- Long-term use of a urinary catheter
- Amiodarone side effects
Epididymitis risk factors
There are a number of factors that can increase a person's risk of developing epididymitis, namely:
- Having sex with people with sexually transmitted diseases without using a condom
- Have a history of sexually transmitted infections, enlarged prostate, or urinary tract infections
- Have had a medical procedure on the urinary tract, prostate, or bladder
- Have abnormalities in the urinary tract
- Not circumcised
Symptoms of Epididymitis
The following are some of the symptoms that people with epididymitis may experience:
- Abnormalities in the scrotum, such as swelling, feeling warm, and red
- Pain, usually in one testicle and appears gradually
- Pain or discomfort in the lower abdomen or pelvis
- Frequent urination
- Pain when urinating
- The tip of the penis discharges fluid or pus
- There is blood in the sperm
- Enlarged lymph nodes in the groin
- Fever
When to go to the doctor
Immediately do an examination to the doctor if you experience the above complaints, especially if there is pain in the testicles that does not go away after 4 days. By seeing a doctor early, the risk of complications due to the epididymis can be avoided.
Diagnosis of Epididymitis
The doctor will ask about the patient's symptoms and medical history, then perform a physical examination to look for signs of epididymitis on the penis and testicles. If necessary, the doctor will perform a digital rectal examination to detect disorders in the prostate gland.
Other tests that the doctor can do are:
- Blood and urine tests, to check for infection in the urinary tract.
- Examination of samples of fluid that comes out of the penis, to detect possible sexually transmitted diseases.
- Doppler ultrasound, to check the smooth flow of blood in the testicles or detect testicular torsion.
Epididymitis Treatment
Treatment of epididymitis aims to overcome the infection and relieve the symptoms experienced by the patient. Treatment methods include:
Drugs
In epididymitis caused by a bacterial infection, the doctor will prescribe antibiotics, such as ceftriaxone, doxycycline, or levofloxacin. Antibiotics are taken for 1-2 weeks. If the infection is a sexually transmitted infection, the patient's partner should also take antibiotics
Patients generally improve within 2-3 days after taking antibiotics. However, it is important to remember that antibiotics should be taken until they are finished even if the symptoms have subsided. After the antibiotics run out, it is advisable to check with a doctor to make sure that the infection is completely gone.
In addition to antibiotics, your doctor can also prescribe pain and inflammation relievers, such as ibuprofen or paracetamol.
Surgery
If an abscess (collection of pus) has formed in the epididymis, the doctor will perform a surgical procedure to remove the pus. In severe epididymitis, your doctor may perform an epididymectomy or surgical removal of the epididymal canal.
In addition to repairing the epididymis, surgery can also be performed to repair abnormal urinary tract and trigger epididymitis.
Self care
Patients can make simple efforts at home to help relieve pain, such as:
- Support the feet to a higher place than the body when lying down so that the scrotum is lifted and not compressed
- Using pants that can support the scrotum
- Compressing the scrotum with cold water
- Don't lift heavy weights
- Don't have sex until it heals
Complications of Epididymitis
If left untreated, epididymitis can last for a long time (chronic) and cause the following complications:
- Abscess (purulent infection) in the scrotum
- Tissue death in the testestesticular infarction) due to lack of blood
- Orchitis, which is inflammation of the testicles that can spread from the epididymis
- Tearing of the skin layer of the scrotum
- Hypogonadism (lack of the hormone testosterone)
- Fertility disorders
Epididymitis Prevention
The way to prevent epididymitis is to avoid factors that can increase the risk of developing epididymitis, namely:
- Have safe sex, namely by using condoms and not changing partners
- Check with your doctor if you have a history of diseases that are at risk of triggering epididymitis
- Consult a doctor about the need to take antibiotics before undergoing surgery
- Do circumcision if you haven't