From the Guidelines
Epididymitis typically presents with unilateral testicular pain and tenderness, hydrocele, and palpable swelling of the epididymis. The signs and symptoms of epididymitis can vary, but common symptoms include:
- Unilateral testicular pain that may radiate to the lower abdomen
- Scrotal swelling and redness
- Tenderness to touch
- A palpable swollen epididymis
- Fever
- Chills
- Urinary symptoms (frequency, urgency, dysuria)
- Urethral discharge
- Blood in the semen As noted in the 1998 guidelines for treatment of sexually transmitted diseases by the Centers for Disease Control and Prevention 1, men who have epididymitis typically have these symptoms, and it is essential to consider testicular torsion, a surgical emergency, in all cases. The evaluation of men for epididymitis should include procedures to rule out other conditions, such as urethritis or urinary tract infection, and to assess for potential complications. Prompt medical attention is crucial to prevent complications, including abscess formation, reduced fertility, or spread of infection to the testicle (epididymo-orchitis), as empiric therapy can result in microbiologic cure of infection, improvement of signs and symptoms, prevention of transmission to others, and a decrease in potential complications 1.
From the FDA Drug Label
Acute epididymo-orchitis caused by N. gonorrhoeae: 100 mg, by mouth, twice a day for at least 10 days. Acute epididymo-orchitis caused by C. trachomatis: 100 mg, by mouth, twice a day for at least 10 days The signs and symptoms of epididymitis are not explicitly stated in the drug label, but it can be inferred that epididymo-orchitis is a condition related to epididymitis.
- The treatment for acute epididymo-orchitis is provided, but the label does not describe the specific signs and symptoms of the condition 2.
From the Research
Signs and Symptoms of Epididymitis
The signs and symptoms of epididymitis include:
- Gradual onset of posterior scrotal pain 3
- Urinary symptoms such as dysuria and urinary frequency 3
- A swollen and tender epididymis with the testis in an anatomically normal position 3
- The pain may be accompanied by other symptoms such as fever, chills, and discharge from the penis 4, 5
Common Causes of Epididymitis
The common causes of epididymitis include:
- Sexually transmitted infections such as Chlamydia trachomatis and Neisseria gonorrhoeae in sexually active males aged 14-35 years 3, 4, 5
- Enteric bacteria in men who practice insertive anal intercourse 3
- Enteric bacteria transported by reflux of urine into the ejaculatory ducts secondary to bladder outlet obstruction in men older than 35 years 3
- Reflux of urine into the ejaculatory ducts in children younger than 14 years 3
Importance of Recognition and Treatment
Recognition and treatment of epididymitis are vital to reduce patient morbidity, as untreated acute epididymitis can lead to: