The epididymis is a structure which lies on and around each testicle. It functions in the transport, storage and maturation of sperm cells originating from the testicle. When a man complains of scrotal pain, acute or chronic epididymitis is far and away that most common diagnosis. It is a narrow, tightly-coiled tube connecting the efferent ducts from the rear of each testicle to its vas deferens.

The epididymis can be divided into three main regions

the head (caput)

the body (corpus)

the tail (cauda)

Causes

The infective agents most likely to cause epididymitis are the bacteria which commonly cause other urinary infections. A much less common cause of epididymitis is the gonorrhea bacteria.

Acute epididymitis causes swelling of the scrotum, pain in the testicles, and sometimes a fever of up to 6 weeks duration or less (usually with a gradual onset over several days).

Some of the possible causes of Epididymitis are included in the list below:

Bladder infection

Prostate infection

Sexually transmitted infection

Chlamydia

Gonorrhea

Symptoms

Symptoms can include :-

A rise in body temperature accompanied by chills

A sore swelling of the epididymis

Hot, reddish scrotal skin

Pain in the stomach and a sick feeling and vomiting.

Symptoms of a urinary tract irritation may also be present. These include burning pain when passing urine and an increased need to urinate. The inflammation can involve the testis, which is very painful and may be described as acute epididymo-orchitis.

Treatment

The treatment for acute epididymitis is well accepted and effective. It includes antibiotics therapy, bed rest, scrotal support ("supporter"), and oral anti-inflammatory drugs (such as Ibuprofen). Each of these modes of treatment is important.

Sexually transmitted infections require special antibiotics, and the patient's sexual partners should also be simultaneously treated.

Application of ice bags may reduce pain. Non-steroidal anti drugs may be of use when there is evidence of a severe inflammatory process. Warm soaks and pain medication help reduce your symptoms.

Radionuclide scanning of the scrotum is the most accurate radiologic method of diagnosis, although it is not routinely available. Color duplex doppler ultrasonography has a sensitivity of 70% and a specificity of 88% in diagnosing acute epididymitis.