Epididymitis

Epididymitis is an inflammation of the epididymis, a tube located at the back of the testicle that stores and carries sperm. This condition primarily affects the male reproductive system and can cause significant pain and swelling in the scrotum. It often results from an infection, which may be bacterial or viral, and can sometimes be linked to sexually transmitted infections. The inflammation can lead to discomfort during urination or ejaculation and may cause fever or general malaise. If untreated, it can affect fertility by damaging the epididymis or spreading infection. The condition is important to recognize early to prevent complications such as abscess formation or chronic pain. Diagnosis and treatment focus on relieving symptoms and addressing the underlying infection.

Epididymitis is defined as inflammation of the epididymis, typically caused by an infectious process. The most common pathogens include Chlamydia trachomatis and Neisseria gonorrhoeae in sexually active men under 35, and enteric bacteria such as Escherichia coli in older men or those with urinary tract abnormalities. The pathophysiology involves retrograde spread of infection from the urethra or bladder to the epididymis, leading to localized inflammation, edema, and pain. Clinically, it presents with unilateral scrotal pain, swelling, and tenderness, often accompanied by dysuria or urethral discharge. It is important to differentiate epididymitis from testicular torsion, a surgical emergency. Complications include abscess formation and infertility if the infection is severe or recurrent. Diagnosis is supported by physical exam findings and laboratory tests including urinalysis and nucleic acid amplification tests for sexually transmitted infections.