Epididymitis:

• Epididymitis an inflammation of the epididymitis which is an elongated structure connected to the posterior surface of the testis. Inflammation is most often caused by bacteria in the urinary tract (a bladder infection) of by bacteria passed between partners during sex. It usually occurs in both tubes, and can be acute or chronic. When the inflammation spreads to a testicle, it is call orchitis. Acute inflammation comes on quickly. Symptoms include:
  
  
• pain and swelling in the scrotum
• an urge to urinate often
• a discharge from the penis
• pain during ejaculation
• fever

  Chronic Inflammation is most often the late phase of an acute infection. Symptoms may include:

• an ache or dull pain in the scrotum, which may spread to the groin
  
• a heavy feeling in the scrotum
  

What Inflammation Does Not Mean

If you have epididymitis or orchitis:

• It does not mean you are impotent.

Evaluation and Treatment

Your doctor diagnoses epididymitis through a physical exam and simple lab tests. Treatment includes medications to get rid of the bacteria. Resting, supporting the scrotum, and using ice packs can help relieve your symptoms. If you are sexually active, any partners need to see a doctor as well.

Physical Exam and Tests

During your physical, your doctor examines your testicles for swelling. Your urethra is checked for any discharge, and you will be asked to give a urine sample. The sample is sent to the lab to find out which bacteria are causing the inflammation. Sometimes a blood test is done. If your doctor finds a mass on a testicle, or a testicle feels twisted, and ultrsound may be ordered. This imaging test uses sound waves to create a picture of the inside of your scrotum.

Physical Exam and Tests

Treatment may include one or more of the following:

• Antibiotics: Acute epididymitis is most often treated with oral antibiotics. You may also be given an injection of antibiotics. Be sure to take all of your medication.
• Anti-inflammatories: Your doctor may prescribe medication to reduce swelling and tenderness.
• Rest: You will most likely need to rest for 3 to 4 days, or until the swelling and fever are gone. Lying down with a towel folded under the scrotum can help relieve discomfort.
• Scrotum support: If your testicles are swollen, you may want to wear an athletic support (jock strap) of spandex bicycle shorts. This helps relieve your discomfort until the swelling goes down.
• Ice and Heat: Putting an ice pack on the scrotum can help decrease any swelling. Once the swelling is gone, sitting in a warm bath increases blood flow to the affected area. This helps to bring more antibiotic to the area and speeds healing.

The Testicles And the Epididymis

The 2 testicles are the male sex organs that produce sperm and male hormones. The testicles lie inside the scrotum. Behind each testicle is a coiled tube called the epididymis. Sperm mature as they pass from the testicle through the epididymis.

Normal Flow of Sperm and Urine

Sperm travel from the testicle through the epididymis into a tube called the vas ferens. During ejaculation, sperm pass out of the body through the urethra. During urination, urine flows from the bladder out through the urethra.

How Inflammation Starts

The urethra contains bacteria. Bacteria can travel from the urethra into the epididymis. This causes inflammation in the epididymis. The inflammation can also spread to the testicle. Sometimes infections, such as mumps, start elsewhere in the body and spread to the epididymis.