Persistent Swelling in the Epididymis: Is It Normal After Treatment?

There are no symptoms anymore, but the epididymis is still swollen?

The onset of symptoms was in October.
During the consultation, a urinalysis was performed, which did not show any significant findings.
An ultrasound revealed the presence of cysts.
After two follow-up visits and two weeks of antibiotics (the doctor mentioned it was a broad-spectrum antibiotic), the pain symptoms resolved, and I did not return for two months.
Upon self-examination, I still feel a small lump.
Is this normal? Is it possible that inflammation could prevent a full return to the original state? Thank you.

Xiao Zhi, 20~29 year old female. Ask Date: 2021/12/14

Dr. Li Xinyi reply Urology

Some cases of epididymitis may result in the formation of cysts in the epididymis after treatment, which generally do not resolve on their own.
Although your description suggests that most cases are not problematic, if you have concerns, it is advisable to consult a urologist for an examination and further discussion with your physician.

Reply Date: 2021/12/14

More Info

Persistent swelling in the epididymis after treatment can be a concerning issue, and it's understandable that you are seeking clarity on this matter. Based on your description, it appears that you experienced an epididymal condition that was treated with antibiotics, which is a common approach for infections or inflammation in that area.
Firstly, it is important to note that the epididymis is a coiled tube located at the back of the testicle, responsible for storing and maturing sperm. Inflammation of the epididymis, known as epididymitis, can occur due to infections, trauma, or other underlying conditions. The treatment typically involves antibiotics, especially if a bacterial infection is suspected.

After completing a course of antibiotics, it is not uncommon for some degree of swelling to persist. This can be due to several factors:
1. Residual Inflammation: Even after the infection has been treated, inflammation can take time to resolve completely. The body may still be in the process of healing, which can lead to lingering swelling.

2. Fibrosis or Scarring: In some cases, inflammation can lead to scarring or fibrosis in the epididymis, which may result in a permanent change in size or shape. This does not necessarily indicate a failure of treatment but rather a natural response to injury or infection.

3. Chronic Epididymitis: If the inflammation was significant, it could lead to a chronic condition where symptoms persist even after the acute phase has resolved. This can manifest as ongoing swelling or discomfort.

4. Other Conditions: It’s also possible that the swelling is related to other conditions, such as a hydrocele (fluid accumulation), spermatocele (cyst containing sperm), or even a varicocele (enlargement of veins within the scrotum). These conditions can sometimes be mistaken for residual swelling from epididymitis.

Regarding your concern about whether the epididymis can return to its original state, it largely depends on the extent of the initial inflammation and any subsequent damage. In many cases, the swelling may gradually decrease over time, but some individuals may experience lasting changes.
If you are still noticing swelling two months after treatment, it is advisable to follow up with your healthcare provider. They may recommend further evaluation, such as a repeat ultrasound, to assess the epididymis and rule out any other potential issues. It’s crucial to communicate any ongoing symptoms or concerns, as this will help your doctor determine the best course of action.

In summary, while some persistent swelling can be normal after treatment for epididymitis, it is essential to monitor the situation and consult with your healthcare provider for a thorough evaluation. They can provide reassurance, further diagnostic testing, and appropriate management options based on your specific circumstances. Remember, timely follow-up is key to ensuring your reproductive health and addressing any potential complications.

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