What is wrong with your groin?
One morning you wake up and notice that it hurts while you’re urinating and you’ve got pain in your testicles. You also realize that your scrotum seems swollen and red. What’s causing this to happen? How is it treated? Can it be prevented?
Definition
Epididymitis is when the coiled tube (epididymis) that is used to store and carry sperm, which is located at the back of the testicle, becomes inflamed. Most often, this is caused by a bacterial infection, such as a sexual transmitted infection (STI) with gonorrhea and chlamydia being the most common causes. However, there are other ways to end up with epididymitis. If you have a urinary tract infection or prostate infection, the bacteria can easily spread to the epididymis. Sometimes, viral infections, like mumps, can cause it. Trauma to your groin can also result in the epididymis becoming inflamed. If you lift something heavy or strain for some reason, it can make your urine flow backward into the epididymis, which can trigger inflammation. This phenomenon is called chemical epididymitis. There are risk factors for developing both sexually transmitted and non-sexually transmitted epididymitis. For sexually transmitted, it can include having a history of STIs, having sex without a condom and having sex with a partner who has an STI. For non-sexually transmitted, having a history of prostate/urinary tract infections, enlarged prostate, uncircumcised penis, abnormality to your urinary tract or a medical procedure that affects your urinary tract.
Symptoms are the same no matter how you get the infection. They include swollen/red/warm scrotum, pain/tenderness in one testicle that comes on slowly, painful urination, urgent/frequent need to urinate, discharge from your penis, pain/discomfort in your lower abdomen/pelvis, blood in your semen and occasionally fever. If you have swelling/pain to your scrotum, discharge from your penis and/or pain when you urinate, you should definitely see a doctor. If the pain is severe, you should go to the emergency room. Epididymitis can result in several complications, like a pus-filled abscess in your scrotum, infection of the testicle itself (epididymo-orchitis) and, in some cases, reduced fertility. Some individuals also experience chronic epididymitis, which is when the infection lasts longer than six weeks or reappears. Typically, symptoms for this appear gradually.
Treatment
The only way to completely get rid of an epididymitis infection is take antibiotics. You’ll begin to feel better within 48-72 hours of starting them. However, it’s important to take the entire course of antibiotics that are prescribed in order to make sure that the infection completely goes away. If your infection was caused by an STI, then your partner(s) should be treated as well. Since epididymitis can be painful, it’s important to rest and lie down so your scrotum is elevated. Applying ice to the area as tolerated and taking over-the-counter pain medication can be helpful in relieving some of your discomfort. Be sure to wear an athletic strap to support your scrotum when you’re not lying down. Don’t lift any heavy objects and avoid having sex until the infection is gone. If you’ve developed an abscess, your doctor will need to drain it. Sometimes, if the abscess is larger, your doctor might need to remove it and potentially part or all of the epididymis to make sure the infected area is gone.
Prevention
In order to prevent epididymitis, there are several things that you can do. The first is to practice safer sex by using condoms, limiting the number of partners you have and being regularly tested for STIs. If you get frequent urinary tract infections, talk to your doctor about ways to prevent epididymitis from occurring. One thing that can definitely help is drinking plenty of water so that your urine is a pale yellow or clear color. This is vital if you spend a lot of time outside, especially during summer when it’s hot. Be careful when lifting heavy objects so you don’t strain too much.
An epididymitis infection can be alarming if you don’t know what’s going on. By knowing what to look for, you’ll be better prepared to seek treatment quickly and will be back to your normal self in no time. If you have any questions or concerns about epididymitis, please speak with your doctor. If you would like more information, please visit the Urology Care Foundation’s Epididymitis page at https://www.urologyhealth.org/urologic-conditions/epididymitis-and-orchitis