Acute Epididymitis: Symptoms, Treatment, and Recovery

Q: Acute Epididymitis: Symptoms, Treatment, and Recovery

Xiao Zhang： Hello, generally, epididymitis requires 6-8 weeks of treatment, and the epididymis may not return to its size prior to inflammation. <br>In other words, your epididymis may be larger than before and could remain so for life. <br>After treatment, as long as the course

Acute left epididymitis

Hello Dr.
Hsu,
On February 15, I suddenly experienced pain in my left testicle, which gradually swelled.
After examination, the doctor diagnosed it as acute left epididymitis.
Symptoms included mild fever and chills.
That day, I was prescribed Diclofenac Sodium 50mg/CAP and Doxycycline 100mg/CAP for three days, and I received an injection of Gentamicin Sulfate 80mg/2ml.
Blood and urine tests were also conducted.

Three days later, during a follow-up visit, the doctor informed me that my urine showed a significantly elevated white blood cell count, but it seems no bacterial culture was performed.
The prescribed medication remained Diclofenac Sodium 50mg/CAP and Doxycycline 100mg/CAP, but the duration was extended to seven days.
The doctor mentioned that recovery would take approximately 6-8 weeks.
I only took pain medication for three weeks and have been on Doxycycline since then, which has now been six weeks.
However, my left testicle remains the same size as it was in the third week and has not decreased.
Additionally, my fingertips have been feeling cold over the past few weeks.
The left testicle also feels uncomfortable at times, with slight pain that does not require pain medication.

I had sexual contact with a girl in early January.
The doctor suggested that the infection was likely not due to sexual transmission, as the incubation period should not be this long.
I also drink plenty of water and do not hold my urine.
Therefore, the doctor could not provide an explanation for why I developed this condition.
Dr.
Hsu, I would like to ask:
1.
Am I not receiving the appropriate treatment, or could there be other underlying causes that have not been identified?
2.
Since the onset of my symptoms, I have refrained from sexual activity.
How long should I wait before resuming? During the antibiotic treatment, is there a risk of transmitting the infection to others?
3.
How long might it take for the swelling of my left testicle to return to normal size?
4.
Occasionally, when I exert myself during bowel movements, I experience a sensation similar to ejaculation, which has occurred intermittently for several years.
What could this indicate?
Thank you.
I had sexual contact with a girl I had known for three months in early January.

Xiao Zhang, 30~39 year old female. Ask Date: 2008/03/31

Dr. Xu Weikai reply Urology

Xiao Zhang: Hello, generally, epididymitis requires 6-8 weeks of treatment, and the epididymis may not return to its size prior to inflammation.
In other words, your epididymis may be larger than before and could remain so for life.
After treatment, as long as the course is completed, it should not be contagious.
Epididymitis is related to urinary tract infections and can also occur due to infections like the flu spreading through the bloodstream to the epididymis.
The most significant complication is that it can cause blockage of the affected side's passage, meaning that sperm cannot be transported from the testis to the appropriate location.
For uncertain safe sexual practices, it is best to use condoms throughout.
If there is a strong urge to ejaculate, there should not be any major issues.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Director Xu Weikai.

Reply Date: 2008/03/31

More Info

Acute epididymitis is an inflammation of the epididymis, often caused by infections, and it can present with a variety of symptoms and complications. Based on your description, it seems you are experiencing a classic case of acute epididymitis, which can be quite distressing. Let’s address your questions one by one.

1. Are you receiving the appropriate treatment?
The medications prescribed to you—Diclofenac Sodium (a non-steroidal anti-inflammatory drug) and Doxycycline (an antibiotic)—are commonly used to treat acute epididymitis. Diclofenac helps alleviate pain and reduce inflammation, while Doxycycline targets bacterial infections. However, if your symptoms persist or worsen, it may indicate that the underlying cause has not been fully addressed. In some cases, additional diagnostic tests, such as a urine culture or imaging studies (like an ultrasound), may be necessary to identify any complications or alternative causes of your symptoms.

2. When can you resume sexual activity?
It is generally advisable to avoid sexual intercourse until you have completed your course of antibiotics and your symptoms have resolved. This is to prevent the risk of transmitting any potential infection to a partner and to allow your body to heal properly. Typically, you should consult your healthcare provider for personalized advice, but a common recommendation is to wait at least one week after completing antibiotics and until you feel completely symptom-free.

3. How long will it take for the swelling to subside?
The duration for the swelling of the epididymis to return to normal can vary significantly among individuals. In many cases, improvement can be seen within a few weeks of starting treatment, but complete resolution may take longer, sometimes up to several weeks or even months. Factors such as the severity of the infection, your overall health, and adherence to treatment can influence recovery time. If the swelling persists beyond the expected timeframe, it is crucial to follow up with your healthcare provider for further evaluation.

4. What about the unusual discharge during bowel movements?
The experience of a discharge that resembles semen during bowel movements is not typical and could indicate a separate issue. This could be related to a condition known as "pre-ejaculatory fluid" or could be a sign of a more complex issue involving the reproductive or urinary systems. It is essential to discuss this symptom with your healthcare provider, as they may want to conduct further examinations or tests to determine the underlying cause.

In summary, while your treatment regimen appears appropriate for acute epididymitis, persistent symptoms warrant further investigation. It’s essential to maintain open communication with your healthcare provider, report any new or worsening symptoms, and adhere to the prescribed treatment plan. Recovery can take time, and your provider can offer the best guidance tailored to your specific situation. Always prioritize your health and seek medical advice when in doubt.

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