What is the recommended approach for patient education on epididymitis?

Patient Education for Epididymitis

Patients with epididymitis must understand the importance of completing their full antibiotic course, avoiding sexual activity until both they and their partners are cured, and returning for reevaluation if symptoms don't improve within 3 days. 1

Understanding the Condition

• Epididymitis causes unilateral testicular pain and swelling of the tube behind the testicle (epididymis), and patients should understand this is typically a bacterial infection requiring antibiotics 1
• The infection source varies by age: in men under 35, it's usually sexually transmitted (gonorrhea or chlamydia), while in men over 35, it's typically from urinary tract bacteria 2, 3
• Untreated epididymitis can lead to serious complications including infertility and chronic scrotal pain, making proper treatment essential 3

Medication Adherence

• Complete the entire 10-day antibiotic course even if symptoms improve earlier, as stopping early can lead to treatment failure and complications 1
• For men under 35: expect to receive an injection (ceftriaxone) plus oral antibiotics (doxycycline) twice daily for 10 days 2
• For men over 35: expect oral antibiotics only (levofloxacin or ofloxacin) once or twice daily for 10 days 2

Symptom Management at Home

• Rest in bed with the scrotum elevated (using a rolled towel or supportive underwear) until fever and swelling subside 1
• Take pain relievers as prescribed to manage discomfort during the acute phase 1
• Apply ice packs (wrapped in cloth) to reduce swelling if recommended by your provider 3

Sexual Activity and Partner Management

• Abstain from all sexual intercourse until both you and your partner(s) have completed treatment and are symptom-free 1
• All sexual partners from the past 60 days must be evaluated and treated if your infection is caused by gonorrhea or chlamydia, even if they have no symptoms 1, 2
• Failure to treat partners leads to reinfection, undermining your treatment and perpetuating transmission 1

Warning Signs Requiring Immediate Return

• Return within 3 days if pain, swelling, or fever don't improve, as this requires reevaluation of the diagnosis and possible treatment change 1
• Seek emergency care immediately if pain becomes sudden and severe, as this could indicate testicular torsion (twisted testicle), a surgical emergency that can cause permanent damage 1
• Return if swelling and tenderness persist after completing antibiotics, as this may indicate complications like abscess, tumor, or testicular cancer requiring further evaluation 1

Follow-Up Testing

• HIV testing and syphilis screening are recommended as part of the evaluation, since sexually transmitted epididymitis indicates risk for other infections 1
• Expect testing for gonorrhea and chlamydia through urine samples or urethral swabs to identify the specific cause 1

Common Pitfalls to Avoid

• Don't assume you're cured when pain improves—the infection requires the full antibiotic course to prevent chronic complications 1, 3
• Don't resume sexual activity prematurely, as this spreads infection to partners and can worsen your condition 1
• Don't ignore persistent symptoms after treatment, as the differential diagnosis includes serious conditions requiring different management 1

Special Considerations

• Patients with HIV receive the same treatment as HIV-negative patients for uncomplicated cases, though immunosuppressed individuals may have fungal or mycobacterial causes requiring different approaches 1, 2
• Men who practice insertive anal intercourse may have enteric bacterial causes and require modified antibiotic coverage 3