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Chronic Epididymitis

  • Male genitourinary system

Definition

Chronic epididymitis is a long-standing inflammation in the epididymis. The epididymis is a coiled, tube-like structure on the back of the testicle through which sperm pass from the testicle to the urethra to be ejaculated.

What is going on in the body?

Chronic epididymitis is an inflammation in the epididymis. Unlike acute epididymitis, chronic epididymitis is not caused by infection. It may be caused by overly sensitive nerves or muscles.

Risks

What are the causes and risks of the condition?

Often, the cause of chronic testicular pain cannot be determined. The risk factors listed here increase a male's risk for chronic epididymitis:
  • past scrotal or groin surgery
  • repeated bouts of acute epididymitis

Prevention

What can be done to prevent the condition?

Because the exact cause is not known, prevention is difficult. Preventing acute epididymitis may reduce the risk. Acute epididymitis is often caused by a sexually infection (STI). Safer sex practices can reduce, but not eliminate, the risk of STIs. However, some men get chronic epididymitis without having these risk factors.

Diagnosed

How is the condition diagnosed?

Diagnosis of chronic epididymitis begins with a history and physical exam. An ultrasound of the scrotum is often done to rule out other conditions.

Long Term Effects

What are the long-term effects of the condition?

Chronic epididymitis may cause chronic pain. However, it has no other serious long-term effects.

Other Risks

What are the risks to others?

Chronic epididymitis is not contagious. It poses no risk to others.

Treatments

What are the treatments for the condition?

Chronic epididymitis can be treated in these ways:
  • injections of steroids or local anesthetics along a nerve
  • muscle relaxing agents, to reduce muscle tension in the area between the scrotum and anus
  • neuromodulating agents, medicines that can be used to treat faulty nerve function in the groin area
  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (i.e., Advil, Motrin) and naproxen (i.e., Anaprox, Aleve, Naprosyn)
  • removal of the epididymis
  • warm baths once or twice a day

Side Effects

What are the side effects of the treatments?

Medicines used to treat chronic epididymitis can cause stomach upset or allergic reactions. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

What happens after treatment for the condition?

Often, symptoms return a few months after treatment. Sometimes, the pain cannot be well controlled. Tests and exams can reassure the man that no serious disease is causing the problem.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

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