Over 90 Percent of What Planned Parenthood Does, Part 11: Diagnosing and Treating Epididymitis

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

Planned Parenthood Arizona treats epididymitis.This statement might raise a few questions:

Q: What’s epididymitis?
A: Epididymitis is the inflammation, or swelling, of the epididymis, resulting in pain in the scrotum.
Q: That’s great, but what the heck is an epididymis?
A: The epididymis is a tube that is connected to the testicle, and is where sperm are stored before ejaculation. The epididymis is 12 to 15 feet long, but is coiled tightly enough to fit inside the scrotum alongside the testes!

Chlamydia causes 70 percent of epididymitis cases in young heterosexuals. This STD is easily treated but frequently asymptomatic — and prevented by condoms.

So, basically, epididymitis is a condition that can strike anyone whose reproductive anatomy features an epididymis. It is generally caused by a bacterial infection — which may be sexually transmitted, such as gonorrhea and chlamydia, or may not be sexually transmitted, such as tuberculosis. Very rarely, epididymitis can be caused by other pathogens, such as viruses, fungi, or parasites. Inflammation of the epididymis can also be caused by the heart medication amiodarone (also known as Pacerone).

Epididymitis most commonly affects males between the ages of 14 and 35. Risk factors, regardless of age, include being uncircumcised, a history of prostate or urinary tract infections, having had surgery in the urinary tract, having a history of a neurogenic bladder, an enlarged prostate, regularly using a catheter, and not using condoms during vaginal or anal intercourse.

The symptoms of epididymitis usually develop over one or two days and can include:

  • fever and chills
  • enlarged lymph nodes in the groin area
  • “heavy” sensation in the testicle area
  • blood in the semen
  • pain during urination or ejaculation
  • penile discharge
  • pain, swelling, or discomfort in the scrotum, groin, or abdominal area
  • a lump in the testicle
  • testicular pain that is aggravated during a bowel movement

In the younger age group, epididymitis is usually caused by sexually transmitted bacteria, including Neisseria gonorrhoeae, Chlamydia trachomatis, and Escherichia coli, which have spread from the urethra to the testicles. While 1 in 5 men with an untreated gonorrhea infection will develop epididymitis, chlamydia is actually the leading cause of epididymitis in heterosexuals 35 years old and younger, accounting for about 70 percent of epididymitis cases in that population. Because chlamydia is so often asymptomatic — half of men with chlamydia have no symptoms — it can be easy for an infection to spread undetected. You can reduce your risk for gonorrhea and chlamydia by using condoms consistently and correctly, and if you’re sexually active you can be easily screened for these sexually transmitted diseases (STDs) at any Planned Parenthood health center — all you’ll need to do is give a urine sample. E. coli is the usual culprit in urinary tract infections, and while the bacteria are not necessarily transmitted sexually, when they are the transmission usually results from performing insertive anal sex. For this reason, condom use during anal intercourse is also very important.

It’s important to be treated for epididymitis, because if left untreated the condition can lead to many complications, including fertility problems, chronic pain in the scrotal area, pus-filled infected tissue, fistula on the scrotum, testicular shrinkage, and the death of testicular tissue.

At a health center, you will receive a physical examination during which a health care provider will look for a lump on the affected side of your scrotum, inspect your lymph nodes in the groin area for enlargement, and examine your prostate to see if it’s enlarged or tender. Other tests might include an ultrasound, a blood test, a urine test, and a screening for gonorrhea and chlamydia.

If you are diagnosed with epididymitis, you will probably be prescribed antibiotics, as well as pain relievers or anti-inflammatory medications if necessary. Be sure to take the full course of antibiotics you are prescribed, even if you feel better before you’re through with them! You’ll be advised to rest in bed while elevating your scrotum and applying ice packs to your groin to reduce swelling. You’ll also come in for a follow-up exam to verify that your infection has been successfully treated.

Before your appointment, you might like to write down a list of your symptoms as well as questions you want to ask your health care provider. In addition to talking about your symptoms, you should also be prepared to talk about your sexual and medical history. Because epididymitis is so commonly associated with STDs, it is important to abstain from all sexual contact until you receive your diagnosis and, if applicable, complete your treatment. If you are diagnosed with an STD like gonorrhea or chlamydia, your sexual partner(s) will also need to be treated — both for their own health as well as to prevent them from reinfecting you.

You can get tested for gonorrhea, chlamydia, and other STDs, as well as be evaluated for epididymitis, at a Planned Parenthood health center. More information about epididymitis can be found at the U.S. National Library of Medicine.