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Pain medicine and applying heat are the standard treatments. If symptoms don't go away, your health care provider may suggest other pain medicine.
Or, recommend a pain management specialist. If all else fails, the epididymis can be surgically removed "epididymectomy". The testis can be left in place. Antibiotics are often the best treatment for bacterial infections. Pain medicine may help reduce symptoms. For infectious cases, it takes two to three days to start feeling better. If you don't, and if the redness doesn't begin to fade, call your provider. Discomfort can last for weeks to months after the full course of antibiotics is taken in some cases.
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It can take months for the swelling to ease. Rest with the scrotum raised for a day or two helps speed healing. Cases of tuberculous epididymitis without surgery may need months to heal with medicine. The testis may shrink after treatment. Symptoms for chronic epididymitis go away eventually or may come and go. Anti- inflammatory medicine may be needed on and off for a months or years.
Symptoms are sometimes better and sometimes worse. If surgery is done, symptoms ease in most men after a few weeks of healing. If surgery hasn't helped, your health care provider will try drugs again. Most acute cases are treated well by antibiotics. Sometimes, a different antibiotic needs to be used or you may require hospitalization with stronger antibiotics given into your veins. If antibiotics don't stop the symptoms, your health care provider may suspect tuberculous epididymitis. If a pocket of pus "abscess" has formed, more must be done. Surgery to drain the abscess or remove part or all of the epididymis might be needed.
This is rare. Other problems that might need surgery: testis death with destroyed blood vessels "testicular infarction" ; an infection that drains through the skin "cutaneous fistula". If your testis has shrunk due to mumps orchitis or tuberculous epididymitis, the testis will make less sperm. In rare cases, the epididymis may be blocked after an infection. This would also reduce sperm from that testis.
If only one testis is affected, then most men are able to father a child normally. In most cases, hormones and sperm production are not affected.
In rare cases, the affected testis may not be able to make testosterone or sperm. Ask your urologist to find out how you're doing. These infections are not linked to cancer. Most cancer of the testes are painless, but a small percentage will start with pain in this area of the body. The Urology Care Foundation is in the process of re-writing this article to make it easier to read and find the information you want.
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Research At the Urology Care Foundation, we support research aimed at helping the millions of men, women and children who struggle with urologic cancer and disease. Home Urologic Conditions Epididymitis and Orchitis. What are Epididymitis and Orchitis? Epididymitis is swelling or pain in the back of the testicle in the coiled tube epididymis that stores and carries sperm. Orchitis is swelling or pain in one or both testicles, usually from an infection or virus. This article will help you manage these health issues with your urologist. What Happens under Normal Conditions?
Acute Epididymitis and Acute Epididymo-orchitis Infections in the scrotum may be caused by an infection somewhere else in the body. Acute Orchitis The symptoms for orchitis are uncommon and can be from a viral or bacterial infection. Symptoms for orchitis caused by the mumps virus "mumps orchitis" include: Mild to severe pain Tenderness Swelling If the mumps virus are the cause, pain in the testis can appear up to 7 days after glands in the face swell.
Acute Epididymitis An "acute" case is most often caused by an infection from bacteria. In children who haven't reached puberty, the infection may start in the bladder or kidney. It then spreads to the testis. Some boys get more urinary tract infections , and may get this more often. In men, a STD sexually transmitted disease is one of the causes.
Mostly from chlamydia, mycoplasma or rarely gonorrhea. These infections start in the urethra. They can then move into the testis. Sometimes there is a discharge of fluid from the urethra. Sometimes it is caused by something else: Enlarged prostate blocking the bladder Infection of the prostate gland "bacterial prostatitis" Partly blocked urethra Recent catheter use Epididymitis is sometimes caused by other things: Chemical or inflammatory non-bacterial epididymitis may happen from urine flowing backwards to the epididymis.
This is most often from heavy lifting. The urine causes swelling but no infection. The drug "Amidarone" can be a cause but this is rare An infection from the bloodstream as with tuberculosis Other unknown causes In any of these cases, the first sign of a problem is often pain in the back of the testis. Chronic Epididymitis A "chronic" case may result after acute epididymitis. Orchitis Orchitis alone is mostly from a mumps virus or other virus infection.
Acute Epididymo-orchitis Acute epididymo-orchitis is most often from a bacterial infection. Other tests may be used, but not often.
The right diagnosis makes sure you get the right treatment. Acute Epididymitis and Acute Epididymo-orchitis Treatment often starts with a week course of antibiotics. The most common antibiotics used are: Doxycycline Ciprofloxacin Levofloxacin Trimethoprim-sulfamethoxazole For bad cases of infection, you may need to stay in the hospital for treatment.
For other types of non-infectious epididymitis, there's no set treatment.