Tuesday, February 23, 2010

The Testicles Are Still Hungry, by Aek

This post is a continuation of The Care and Feeding of the Testicles.  According to a birdie in the frozen Northlands, apparently they’re still hungry – go figure.  In this post I’ll touch on 2 other fairly common problems that can occur with the testicles: epididymitis and orchitis.

First, some warning signs/symptoms indicating that you must see your doctor ASAP:

- tender or swollen scrotum persisting for more than 2-3 days
- discomfort and/or pain in the testicles that last more than 2-3 days
- discomfort and/or pain in the testicles that progressively worsens throughout the day
- pain that radiates (spreads) from the testicles to the groin and lower abdomen
- blood in semen (never never a good thing)

What is it?
It is an inflammation of the epididymis, the coiled tube at the back of the testicles where sperm is matured and stored.  (Note: again, any word that ends with “-itis” means inflammation of.)  Epididymitis may be either acute or chronic.  It seems to be more common in guys under 40, particularly those who have unprotected anal sex.  Epididymitis is the most frequent cause of sudden pain in the scrotum. 

How is it diagnosed?  What’re some symptoms?
Epididymitis is often caused by a bacterial infection (usually, but not always, an STD).  The most common cause of epididymitis is chlamydia, followed by gonorrhea, and then followed by other random non-STD infections (like from E. coli).  Non-infectious causes of epididymitis can also occur.  It may be difficult to tell the difference between epididymitis and testicular torsion (both are bad, btw).  A good physical exam is a necessary starting point.  The Cremaster reflex may be tested; if it works, then it’s less likely to be testicular torsion.  Urinalysis will be done to determine if it’s infectious in origin, and ultrasound is the preferred test.  Symptoms include the 5 warning signs above; chills, fever, and/or painful urination/ejaculation are also possible. 

Is it serious?
Yes!  Epididymitis can indeed be serious.  Other than persistent pain, epididymitis can damage the testicles and in some cases lead to reduced fertility or infertility.  If an acute case of epididymitis goes untreated, it may develop into chronic epididymitis.  Pus may also form in the scrotum (very unpleasant sounding).  In rare cases, one may lose a testicle if epididymitis goes untreated for too long. 

How is it treated?
Most cases of epididymitis are treated with antibiotics against the infectious bacteria.  Symptoms should clear away after a few days.  Bed rest, elevating the scrotum, and NSAID (non-steroidal anti-inflammatory drug) pain killers are also indicated.  If symptoms persist for more than 3 days after treatment begins, see your doctor ASAP as further work-up may be necessary.  Also, if pus forms, it must be drained.  Surgery is rarely indicated (as very severe cases are rare). 


What is it?
Orchitis is an inflammation of the testicles.  It can be related to epididymitis if the infection spreads.
How is it diagnosed?  What’re some symptoms?
Orchitis is pretty similar to epididymitis and often caused by the same things.  The diagnostic tests for orchitis is the same as that for epididymitis, and the symptoms of these two are (you guessed it) very similar as well.  See above for more details. 

Is it serious?
Yes!  Orchitis can lead to the same things as epididymitis (so again, see above). 

How is it treated?
The treatment for orchitis is the same as that for epididymitis.  So see above.
Take Home Message:
If you experience the 5 warning signs at the top, you need to see your doctor ASAP!!  No excuses unless you’re in the middle of nowhere.  It doesn’t matter if you’ve had unprotected sex, or have had sex at all even – epididymitis and/or orchitis can still happen from a non-STD infection.  The possible consequences of not going to the doctor are . . . well, you’ve read them above.


georg clerk said...

The disease caused by bacterial infection will require at least two weeks of antibiotic treatment. The medications given can include doxycycline, azithromycin, ofloxacin, ciprofloxacin, levofloxacin or trimethoprim-sulfamethoxazole. Cases caused by Mycobacterium tuberculosis will be treated by anti-tuberculosis medications. General treatment includes bed rest, elevation of scrotum and application of ice. The elevation will raise the scrotal sac above the level of heart improving blood flow and aids in rapid healing. Intake of plenty of water is recommended. Other than these non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen can also be of assistance. If amiodarone is the suspected causes then adjustment of the drug dose is recommended. The severe cases with exaggerated symptoms such as intractable pain, vomiting, very high fever or overall severe illness may require hospital admission. Surgical removal of testis may be required as treatment of Epididymitis in complicated cases. In case of chronic illness treatment is mainly directed towards reducing the discomfort.

Margla Clerk said...

Hello everyone! Hope you are having a good day. We have some interesting article for you on what to expect after the treatment of Epididymitis? While researching online on the disease we came across this interesting and informational excerpt on the ugologyhealth.org.
Posting here the extract of a long article on the disease, causes, symptoms and other related headers for your information!
Reference: www.urologyhealth.org