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Epididymitis

Mixed pathogens Chlamydia trachomatis, Neisseria gonorrhoeae, Escherichia coli, among others

Overview

Epididymitis is inflammation of the epididymis, typically occurring unilaterally. In sexually active young men (<35 years), predominantly caused by STD pathogens (chlamydia, gonorrhea). In older men (>35 years), primarily caused by urinary tract pathogens (E. coli and other uropathogens). May present as acute or chronic inflammation. Untreated cases may lead to serious complications including epididymal abscess, testicular infarction, and infertility.

Transmission Routes

  • Sexual contact: Young men primarily develop ascending infection from STD pathogens (chlamydia, gonorrhea)
  • Retrograde urinary tract infection: Urinary tract infection bacteria ascend through vas deferens to epididymis, common in older men or those with urinary tract abnormalities

Typical Symptoms

Scrotal pain (unilateral, gradually worsening), radiating to groin
Scrotal swelling, redness, tenderness
Epididymal enlargement, marked tenderness
Fever, chills
Urethral discharge (STD-related)
Dysuria, urinary frequency, urgency
STD-related epididymitis usually has gradual onset; urinary tract infection-related has acute onset
Complications: Epididymal abscess, testicular infarction, infertility

Prevention Measures

  • Use condoms correctly
  • Monogamous relationship
  • Timely treatment of urethritis and prostatitis
  • Avoid urinary retention and prolonged sitting
  • Regular STD screening
  • Simultaneous testing and treatment of sexual partners
  • Maintain personal hygiene

Treatment Recommendations

Young sexually active men: Antibiotics covering chlamydia and gonorrhea (ceftriaxone + doxycycline), course at least 10-14 days. Older men: Antibiotics covering urinary pathogens (fluoroquinolones). Supportive care: Bed rest, scrotal elevation, ice packs, analgesics. Sexual partners require simultaneous treatment. Abscess formation may require surgical drainage.

When to Seek Medical Help

  • If you experience any of the symptoms listed above
  • After unprotected sexual contact
  • If a sexual partner has been diagnosed with an STD
  • For regular screening if sexually active

Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult with a healthcare provider for diagnosis and treatment of any medical condition.