Epididymitis: Causes, Symptoms, and Treatment Options

Q: Epididymitis: Causes, Symptoms, and Treatment Options

Hello： On December 26, 2021, I had unprotected sexual intercourse (followed by a simple rinse and urination). <br>On December 30, 2021, I had protected intercourse, but on the night of January 1, 2022, I experienced swelling in the left epididymis. <br><br>1. <br>Is there a high

Epididymitis

Hello Doctor, on December 26, 2021, I had unprotected sexual intercourse (followed by a simple rinse and urination).
On December 30, 2021, I had protected sex, but on the night of January 1, 2022, I experienced swelling of the left epididymis.
I would like to ask: 1.
Is there a high probability that epididymitis could be transmitted from the two sexual encounters mentioned? (There were no unusual symptoms during urination after the sexual activities.) 2.
If the transmission is due to sexual activity, would the female partner show obvious symptoms of infection? Or could the female partner be asymptomatic but still have the potential to transmit bacteria? Additionally, I visited a urologist on January 3, who diagnosed me with epididymitis and prescribed Norfloxacin film-coated tablets for 7 days.
I have been taking them regularly for two to three days, but the epididymis still feels somewhat firm and has not significantly reduced in swelling.
Should I return for an earlier follow-up? Thank you.

Chen, 20~29 year old female. Ask Date: 2022/01/05

Dr. Jian Weihong reply Urology

Hello: On December 26, 2021, I had unprotected sexual intercourse (followed by a simple rinse and urination).
On December 30, 2021, I had protected intercourse, but on the night of January 1, 2022, I experienced swelling in the left epididymis.

1.
Is there a high likelihood that epididymitis could be transmitted from the two sexual encounters mentioned? (There were no unusual symptoms during urination after the sexual activities) --> It is possible.

2.
If the infection was transmitted through sexual activity, would the female partner show obvious symptoms? --> Not necessarily.
Could the female partner be asymptomatic but still have bacterial transmission potential? --> It is possible.

Additionally, I visited a urologist on January 3 and was diagnosed with epididymitis, and I was prescribed Norfloxacin film-coated tablets for 7 days.
After taking them regularly for two to three days, I still feel that the epididymis is somewhat hard and there is no significant reduction in swelling.
Should I return for an earlier follow-up? --> If the epididymitis has not worsened, it is under control, but complete resolution of swelling may take time; some patients may take several weeks.
If any of the symptoms such as redness, swelling, heat, or pain worsen, you should return for a follow-up immediately.

Reply Date: 2022/01/05

More Info

Epididymitis is an inflammation of the epididymis, a tube located at the back of the testicle that stores and carries sperm. Understanding its causes, symptoms, and treatment options is crucial for effective management.

Causes of Epididymitis
Epididymitis can be caused by various factors, primarily infections. The most common infectious causes include sexually transmitted infections (STIs) such as Chlamydia trachomatis and Neisseria gonorrhoeae, particularly in younger sexually active men. In older men, urinary tract infections (UTIs) caused by bacteria like Escherichia coli are more prevalent. Non-infectious causes can include trauma, certain medications, or conditions like vasectomy.

Symptoms of Epididymitis
The symptoms of epididymitis typically include:
- Swelling and tenderness: The affected epididymis may become swollen and painful, often on one side.

- Pain: This can range from mild discomfort to severe pain, which may radiate to the lower abdomen or groin.

- Redness and warmth: The scrotum may appear red and feel warm to the touch.

- Urinary symptoms: These can include pain during urination, increased frequency of urination, or discharge from the penis.

- Fever: In some cases, fever may accompany the inflammation.

Treatment Options
Treatment for epididymitis typically involves antibiotics if an infection is present. The choice of antibiotic will depend on the suspected cause of the infection. For STIs, a regimen that covers both Chlamydia and Gonorrhea is often prescribed. In cases where a UTI is suspected, antibiotics targeting the specific bacteria will be used.
In addition to antibiotics, supportive care is essential. This may include:
- Rest: Avoiding strenuous activities can help reduce discomfort.

- Ice packs: Applying ice to the scrotum can help alleviate swelling and pain.

- Pain relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can be used to manage pain and inflammation.

Addressing Your Concerns
1. Risk of Transmission: Given your history of unprotected sexual intercourse, it is possible that the epididymitis could be related to a sexually transmitted infection. However, the absence of urinary symptoms does not rule out an STI. It is important to note that some infections can be asymptomatic in women, meaning they may not exhibit noticeable symptoms but can still transmit the infection.

2. Symptoms in Female Partners: Women can carry STIs without showing symptoms, which is why regular screenings are recommended for sexually active individuals. If your partner was infected, she might not have any obvious signs but could still be capable of transmitting the infection.

3. Follow-Up Care: If you have been taking the prescribed antibiotics for a few days and are still experiencing hardness and swelling in the epididymis, it is advisable to follow up with your healthcare provider. Persistent symptoms may indicate that the infection is not responding to treatment, or there may be another underlying issue that needs to be addressed.

In conclusion, while epididymitis can be a distressing condition, understanding its causes, symptoms, and treatment options can help in managing it effectively. If you have concerns about your symptoms or treatment progress, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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