Epididymitis

Diagnosis

To diagnose epididymitis, your healthcare provider will discuss your symptoms and perform a physical examination of your groin. This examination may include checking for enlarged lymph nodes and assessing whether one testicle is swollen or tender. A rectal exam may also be performed to evaluate the prostate for enlargement or tenderness.

Common diagnostic tests include:

• STI screening: A narrow swab is inserted into the end of the penis to collect a sample of any discharge. The sample is tested for sexually transmitted infections such as gonorrhea and chlamydia.

• Urine and blood tests: These tests help identify signs of infection or other underlying causes.

• Ultrasound: This imaging test uses sound waves to create pictures of the testicles. It helps distinguish epididymitis from testicular torsion, a serious condition where the testicle twists and cuts off its blood supply. Lower blood flow may suggest torsion, while increased flow may indicate inflammation from epididymitis.

Treatment

Treatment for epididymitis focuses on eliminating infection, relieving symptoms, and preventing complications. The approach depends on the cause and severity of the condition.

Antibiotics
Antibiotics are prescribed to treat bacterial infections causing epididymitis or epididymo-orchitis, which is an infection that has spread to the testicle. If the infection is sexually transmitted, sex partners should also receive treatment. It is important to complete the entire course of antibiotics even if symptoms improve early to ensure the infection is fully cleared.

Comfort measures
Most people begin to feel better within two to three days after starting antibiotics, but pain and swelling can take several weeks to subside. Home care measures can help relieve discomfort, including:

• Resting and avoiding strenuous activities

• Supporting the scrotum with an athletic supporter

• Applying ice packs to reduce swelling

• Taking over-the-counter pain medications as directed

A follow-up appointment may be recommended to confirm that the infection has resolved completely.

Surgery
Surgical intervention may be necessary in certain cases, such as when an abscess forms or when structural problems in the urinary tract contribute to recurrent infections. Procedures may include draining an abscess or performing an epididymectomy, which involves removing part or all of the epididymis. Surgical repair may also be done to correct underlying anatomical abnormalities.