What You Should Know About Epididymitis (Abnormal Penile Discharge)

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Epididymitis is one of the male fertility-associated diseases. 

Men of any age can develop epididymitis. However, the disease occurs mostly in men aged from 14 to 35 years.

This disease usually occurs due to a bacterial infection in the reproductive organs or sexually transmitted diseases (STDs).

Symptoms include testicle pain, pain in the pelvic area, and swollen scrotum. If you experience these symptoms, seek immediate consultation with an urologist.

What is Epididymitis?

Epididymitis is an infection or inflammation of the epididymis. The epididymis is a tube connecting the rear of the testicles to the deferent duct (vas deferens).

This duct serves to store and carry sperm, which will pass through the ejaculatory duct, prostate gland, urethra (urinary tract), to ejaculation.

The epididymal duct is attached to the testes, so if there is infection or inflammation due to bacteria or viruses, the testes will also experience the same thing. This condition is called orchitis.

When men have epididymitis, the epididymal duct will swell and cause pain. This inflammation can spread to the testicles if not treated immediately.

According to the Centre for Disease Control and Prevention (CDC), acute epididymitis will last for less than 6 weeks if conditions improve. In most cases of acute epididymitis, the testicles are also inflamed. Therefore, it is difficult to find out whether it is the epididymis, testes, or both, that are inflamed.

Chronic epididymitis may last more than 6 weeks. This condition may be caused by a granulomatous reaction which runs a high risk of causing cysts or calcifications.

Symptoms of Epididymitis

Epididymitis can occur along with some mild symptoms. However, if left untreated, the symptoms will get worse. If you have epididymitis, you may experience the following symptoms:

  • Testicle pain
  • Pelvic pain
  • Fluctuating body temperature.
  • Low-grade fever and chills.
  • Nausea
  • Frequent need to urinate with abnormal discharge.
  • Enlarged lymph nodes in the groin.
  • Abnormal discharge or discharge at the tip of the penis.
  • Swelling of the scrotum, the sac that lines the testicles.
  • Painful bladder and bowel issues 
  • Hematospermia (blood in the sperm).
  • Painful ejaculation 

Chronic epididymitis lasts more than 6 weeks and recurs. Symptoms of chronic epididymitis may appear gradually. In fact, many sufferers do not realize they have chronic epididymitis.

Consult a urologist if you feel pain in the scrotum.  You may need treatment as soon as possible to avoid permanent damage.

Seek immediate care from your doctor if the tip of your penis is draining or feels sore and painful when urinating.

Causes of Epididymitis

Most cases of epididymitis are caused by bacterial infections that move through the urethra, prostate, vas deferens, to the epididymis.

Epididymitis can also be caused by sexually transmitted infections (STDs). Bacterial species that can trigger epididymitis are chlamydia trachomatis and neisseria gonorrhoeae, which are often transmitted through sexual contact.

Apart from bacterial infections, epididymitis can also be caused by:

  • Behcet, chronic inflammation in the blood vessels.
  • Tuberculosis (TB), an infection caused by the bacteria called Mycobacterium tuberculosis.
  • Testicular torsion, a condition where the testicle is twisted causing sudden pain.
  • Mumps, a viral infection that causes inflammation of the parotid glands.
  • Side effect of amiodarone — medicines to maintain steady heartbeat.
  • Urine in the epididymis. This condition occurs when urine flows backward into the epididymis,

There are other factors that can increase your risk of developing epididymitis: 

  • Never been circumcised.
  • Use of a urine catheter.
  • Urinary tract obstruction
  • Inflammation of the prostate gland
  • Urinary tract abnormalities
  • Groin injury or trauma.
  • Have been infected with sexually transmitted disease.
  • Have had urinary tract infections and prostate infections.
  • Have had medical treatment that affects the urinary tract

Epididymitis may also affect children. The causes may include:

  • Groin injury or trauma.
  • Testicular torsion, where the testicle is twisted causing sudden pain.
  • Urinary tract infection that spreads through the urethral tract to the epididymis.
  • Urine in the epididymis. This condition occurs when urine flows backward into the epididymis

How Does Epididymitis Affect Male Fertility?

There are many factors that can affect male fertility, such as an unhealthy lifestyle and serious diseases. If not treated promptly, the condition of your epididymitis can worsen. Your doctor may recommend removing partial or the entire epididymis if it does not improve. This will have an impact on sperm quality, which eventually affects your fertility.

Certain complications may arise if you have epididymitis – one of which is epididymal obstruction. This condition is a common cause of male infertility.

Pain in the scrotum or testicle from the epididymitis may damage the function of the testes as the sites of sperm production. 

Treatment for Epididymitis 

The doctor will treat the infection and relieve the symptoms of epididymitis. You will be prescribed medications such as:

  • Antibiotics. You must continue to take your antibiotics even after the symptoms have improved. This is to ensure you are free from infection. Antibiotics are usually given through oral pills, injections, or infusions. The doctor may prescribe two types of antibiotics, doxycycline and ciprofloxacin. 
  • Pain relievers. You will feel pain from the swelling of the epididymis, testicles, or both. Therefore, the doctor will prescribe pain relievers, such as paracetamol or ibuprofen.

Additionally, your doctor may also recommend home remedies to relieve epididymitis symptoms, such as: 

  • Apply ice packs to the scrotum 
  • Avoid heavy-lifting until you completely recover
  • Wear scrotal support when resting
  • Wear athletic supporter (jockstrap) to control swelling and ease symptoms

If your condition does not improve or you notice discharge or pus at the tip of your penis, your doctor may recommend a surgical removal of the epididymis. This surgery is also recommended to treat abnormal anatomy. 

Have questions about epididymitis or fertility? Leave your question in the comment section below.

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