Epididymitis: “a real ball ache!”

Posted 30 July 2019 in Men's Health

Source: medicalimages.com. Testicle shown in purple with epididymis running along back.Epididymitis is a painful condition which affects men and has several causes, with a major cause being sexually transmitted infections (STIs), particularly in men under the age of 35. Most cases can be resolved with a course of antibiotics. (1)

What is epididymitis?

Epididymitis is the medical term for inflammation of the epididymis, which is a tube which runs along the back of the testicle. Both testicles have an epididymis and it is possible for one or both to become inflamed. When the condition also affects the testicles themselves, it can be known as epididymo-orchitis (orchitis means inflammation of the testicle(s)). (1)

What are the symptoms of epididymitis?

Epididymitis symptoms can include:

  • Pain in one or both testicles (the onset of epididymitis pain can be sudden or gradual)
  • A painful, swollen, tender scrotum which can feel hot to the touch
  • Fluid collecting around the testicle(s), giving a swollen or lumpy appearance and feel
  • Trouble passing urine
  • Discharge from the tip of the penis - this can be white, yellow or green, which signals an infection (1)

What are the causes of epididymitis?

There are a number of epididymitis causes, but the most common is an untreated STI - the main culprits being chlamydia and gonorrhoea - especially in men under 35 years of age. A less common cause is a urinary tract infection (UTI), which is rare in men. However, men are at higher risk of a UTI if they have an enlarged prostate gland, a urinary catheter, or are recovering from groin, prostate or bladder surgery. Even less commonly, epididymitis can be caused by mumps, tuberculosis, injury to the groin area, Behçet's disease (an autoimmune condition affecting the blood vessels), and can be a side effect of the heart medication amiodarone. (1)

How is epididymitis treated?

Epididymitis treatment in most cases is a course of antibiotics. The aim of treatment is to clear up both the primary infection (e.g. the STI or UTI) as well as the associated epididymitis. It is important that the course is completed, even if symptoms ease off - otherwise the infection will most likely persist and symptoms will return. It can take as long as two weeks to feel completely better.

Over-the-counter painkillers can be used alongside antibiotics. Ibuprofen is the best choice because of its anti-inflammatory action. A cold pack can also be applied to the area to help soothe burning and inflammation.

Antibiotics for epididymitis can be prescribed by your GP, but are also available from sexual health clinics and, if the epididymitis is linked to chlamydia or gonorrhoea, they can be purchased from Webmed Pharmacy.

Wearing supportive underwear can also help to ease epididymitis pain. (1)

What is chronic epididymitis?

Chronic epididymitis is inflammation of the epididymis that has persisted for a long time, and it may come and go. The pain tends to be milder, but can be more widespread, affecting the rest of the groin area and even the thighs and lower back. A cause is rarely found. Chronic epididymitis treatment is most commonly a course of anti-inflammatory drugs, usually ibuprofen taken for at least two weeks. Occasionally, chronic epididymitis is caused by a long-standing infection and can be treated with antibiotics. (2)

References

  1. The British Association of Urological Surgeons. Chronic Epididymitis [cited 22 July 2019]. Available at: https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Chronic%20epididymitis.pdf

Author
Gabby Gallagher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
30th July 2019

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