Prostatitis And Epididymitis: What You Should Know
The mans body, particularly the prostate gland and testes, can face all kinds of problems.
This includes an enlarged prostate, the occasional urinary tract infection, or a recurrent urinary tract infection. But, prostatitis and epididymitis are known to impact a major portion of the population.
Although they are entirely different conditions, there are similarities between the two that men should be wary of.
Here, you can take a closer look at both epididymitis and prostatitis from a medical perspective.
Management Of Sexual Partners
Sexual partners of the patient should be informed and evaluated for treatment if the cause of epididymitis is suspected or confirmed to be N gonorrhoeae or C trachomatis and sexual contact occurred within 60 days before symptom onset.2 Treatment of sexual partners is important to decrease the transmission of infection and prevent complications associated with infection. Failure to treat sexual partners results in negative outcomes for the patient as well as any sexual partners. The patient may experience recurrence of infection and epididymitis, and the sexual partner may experience complications of infection. Common female complications of untreated infection include pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic abdominal pain.4,21 A serious complication of untreated infection in men, epididymo-orchitis, may result in infertility.21,22
Patient-delivered partner therapy is the most common way that expedited partner therapy is executed. In this method, a physician provides a prescription for antibiotic treatment to the patient to give to his or her sexual partner.16,23 Patient-delivered partner therapy should only be considered if it is appropriate for the individual case and legal within the state.16,23
How Is Epididymitis Diagnosed
Your healthcare provider may examine your penis, prostate, and scrotum. He may ask about your symptoms and any health conditions you have. You may need any of the following tests:
- Blood and urine tests may be done to see if you have an infection. If you have discharge, a small amount of this fluid will be tested for bacteria.
- An ultrasound uses sound waves to show pictures of your testicles on a monitor. An ultrasound may be used to check blood flow to your testicles.
- A nuclear scan checks the blood flow in your testicles. A small amount of radioactive material may be injected into your blood. The radioactive material helps your blood vessels show up better.
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How Do I Get Rid Of A Cyst On My Testicle
Your doctor will insert a needle into the cyst to remove some of the fluid. If the cyst refills and comes back, your doctor can do a procedure called a sclerotherapy. Your doctor will drain some of the fluid from the spermatocele. Then theyll use a substance that causes the sac to fill with scar tissue.
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Do I Need To Follow Up With My Doctor After Treatment
Follow-up with your health care practitioner to ensure the antibiotics are working.
- If the individual does not respond to antibiotics, he may need an ultrasound .
- It is important to be sure that the condition doesn’t progress to become orchitis, an infection of one or both testicles. Orchitis also can result from the spread of bacteria through the blood from other locations in the body. This is called epididymo-orchitis if the epididymitis is also infected.
- Less commonly, a testicular tumor may be present. An ultrasound or blood test might be needed if tumor is suspected.
- If epididymitis occurred because of sexual transmission of infectious bacteria, all sex partners of the man should be notified and treated even if they have no current symptoms.
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What Is The Fastest Way To Get Rid Of Epididymitis And Prostatitis
Antibiotic treatment may be the most viable choice. But, the doctor may also suggest rest, pain meds, applying ice packs, or taking laxatives if releasing feces becomes a real challenge.
Just make sure to consult with a specialist as soon as you spot any aches, discomfort, swelling, or other uncomfortable symptoms.
Check If It’s Epididymitis
Symptoms of epididymitis may include:
- sudden or gradual pain in 1 or both of your testicles
- the bag of skin containing your testicles feeling tender, warm and swollen
- a build-up of fluid around your testicle that feels like a lump or swelling
You may have other symptoms depending on the cause, such as difficulty peeing, or a white, yellow or green discharge from the tip of the penis.
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How To Prevent Epididymitis
Epididymitis is associated with a number of symptoms that are, we can safely say, uncomfortable and frustrating. The condition affects a patients quality of life as it prevents you from performing activities you used to do with ease.Since you have to elevate your scrotum and decrease physical activity time, you might have to take a few days off work especially if symptoms are unbearable.
At the same time, the condition can affect an adult patients relationship. As a man, you dont feel comfortable discussing problems affecting reproductive system with your wife, girlfriend, friends, or anyone else. Keeping things to yourself causes a friction in the relationship.
Good news is that you can prevent epididymitis. Heres how:
- Abstinence
- Maintaining proper hygiene prior to and after sexual intercourse
- Maintain adequate hygiene in genital area, particularly anal region
- Monogamy where both partners are healthy and free of any STD
- Mumps vaccination
- Wear a condom to prevent getting an STD
Since most cases of this condition among adult men are caused by sexually transmitted infections, preventative measures center around practicing safe sex and avoiding engaging in high-risk sexual behaviors.
Although having multiple sexual patterns is considered a proper alpha male lifestyle in the modern age, it increases the risk of developing STDs, epididymitis and many other problems.
Uncommon Causes Of Epididymo
Other viral infections are uncommon causes of epididymo-orchitis. Infection from other parts of the body can, rarely, travel in the blood to the testicles, such as tuberculosis and brucellosis. When this happens it is usually in people who have a problem with their immune system . Schistosomiasis is a tropical infectious disease that can cause epididymo-orchitis. Men with Behçets disease may develop inflamed testicles to cause a non-infective epididymo-orchitis. Injury to the scrotum can cause inflammation of the epididymis and testicle.
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Symptom: Inflammation Of The Scrotum
If your scrotum is red and swollen, you might have epididymitis. Besides inflammation, your scrotum may also feel abnormally warm. The lymph nodes in the groin area may also be enlarged and swollen. You should never ignore these symptoms. Although a variety of health ailments can cause scrotal swelling, you should seek medical treatment immediately to avoid any permanent damage.
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Just How Do Individuals Get Gonorrhea
Gonorrhea is sent with sex-related contact with the penis, vaginal area, mouth, or rectum of an infected companion. Ejaculation does not have to happen for gonorrhea to be sent or acquired. Gonorrhea can likewise be spread perinatally from mom to baby during giving birth.
People who have actually had gonorrhea and got therapy might be reinfected if they have sex-related contact with an individual infected with gonorrhea.
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How Is Epididymitis Treated
Epididymitis caused by bacteria is treated with antibiotics, most often doxycycline , ciprofloxacin , levofloxacin , or trimethoprim-sulfamethoxazole . Antibiotics are usually taken for 1 to 2 weeks.
Men who have epididymitis can also relieve their symptoms by:
- Resting
- Taking anti-inflammatory medications for the pain
Relieving Pain And Discomfort
Tip: If you dont have an ice pack, a bag of frozen peas or corn also works well. Wrap a cloth or paper towel around it before you place it on your scrotum.
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What Causes Epididymitis
Most cases of epididymitis are caused by an infection, usually by the bacteria Mycoplasma or Chlamydia. These infections often come by way of sexually transmitted diseases. The bacterium E. colican also cause the condition. Other infections, including with the mumps virus and, rarely, tuberculosis, can also cause epididymitis.
Sometimes epididymitis occurs when urine flows backward into the epididymis. This can happen as a result of heavy lifting. Other causes of epididymitis include:
- Blockage in the urethra
- An enlarged or infected prostate gland
- Use of a catheter
- Traumatic groin injury
How Common Is Epididymo
- Epididymitis is a common condition with incidence ranging from 25-65 cases per 10,000 adult males per year, and can be acute, chronic or recurrent.
- Acute epididymitis most commonly occurs in patients aged 15-35 years and patients older than 60 years.
- Prepubertal epididymitis is much less common . However, prepubertal epididymitis is thought to be more common than was once believed. It is thought to be a postviral infectious phenomenon.
- Mumps orchitis occurs in up to 40% of postpubertal boys with mumps it is rare in prepubertal boys. An outbreak starting in 2004 and lasting for some three years was seen in England and Wales and was attributed to a reduction in the uptake of measles-mumps-rubella vaccine during the early to mid-1990s in children who subsequently matured.
- Testicular tuberculosis is rare and the diagnosis is frequently delayed or may be missed.
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When To Seek Medical Care
Mild scrotal pain, urinary symptoms, or any of the other symptoms of epididymitis listed above merit a visit to a health care practitioner because the treatment for epididymitis involves prescription antibiotics. If the doctor is concerned about complications or an alternative diagnosis, the individual will likely be sent to a hospital for further tests. If a boy or man has scrotal pain or urinary symptoms and cannot be seen soon by a health care practitioner, he should go to a hospitals emergency department. Symptoms that require urgent care include the following:
Severe scrotal pain: This could represent testicular torsion, which is a very serious disease that needs immediate attention. The outcome for this particular diagnosis is time dependent. The faster the man receives treatment, the less damage may be done since torsion limits or cuts off blood flow to the testicle. Seek care immediately.
Urinary symptoms such as:
- Abdominal or flank pain
- Lumps or swelling in the testicles one testicle increasing in size
These symptoms may indicate an epididymitis infection, but a health care practitioner needs to examine the individual to help determine the diagnosis and determine if an emergency condition exists .
Why Is This Important
In patients younger than 39, the epididymitis is usually caused by same bacteria that are involved in STDs such as Chlamydia and gonorrhea. About 50% to 60% all cases of the condition account for organisms that are responsible for Chlamydia.
These bacteria are called Chlamydia trachomatis, the most common cause of curable bacterial STI worldwide. On the other hand, Neisseria gonorrhoeae is the name of bacteria that cause gonorrhea and could also cause epididymitis during unprotected sex.
The most common causes of the epididymitis in men older than 39 are coliforms which are bacteria like Escherichia coli usually found in the intestinal tract of both humans and animals. These microorganisms are also present in your waste, water, and soil.
Even though most coliforms dont cause any disease, some of them do. In some instances, coliforms can cause bladder infections. How do coliforms cause epididymitis? Men get infected with E. coli or other types of coliforms through anal intercourse.
The STDs arent the only infections that lead to the epididymitis. The condition can also occur when bacteria from a urinary tract or prostate spread from the affected site to the epididymis, as mentioned above, but viral infections like mumps virus can play the role too.
Urine in the epididymis is yet another potential cause of this condition. This happens when urine flows backward into the epididymis after heavy lifting and straining.
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Management Of Sex Partners
Men who have acute sexually transmitted epididymitis confirmed or suspected to be caused by N. gonorrhoeae or C. trachomatis should be instructed to refer all sex partners during the previous 60 days before symptom onset for evaluation, testing, and presumptive treatment . If the last sexual intercourse was > 60 days before onset of symptoms or diagnosis, the most recent sex partner should be evaluated and treated. Arrangements should be made to link sex partners to care. EPT is an effective strategy for treating sex partners of men who have or are suspected of having chlamydia or gonorrhea for whom linkage to care is anticipated to be delayed . Partners should be instructed to abstain from sexual intercourse until they and their sex partners are treated and symptoms have resolved.
Whats The Link Between Prostatitis And Epididymitis
The main connection between prostatitis and epididymitis is in the prostatitis complications. If acute or chronic prostatitis were to be left unmanaged and causes complications, it could lead to inflammation of this particular coiled tube.
E Coli or other gram-negative Enterobacteriaceae tend to trigger chronic bacterial prostatitis . This prostatitis type often impacts 36 to 50 years old men. After an episode of acute bacterial prostatitis, roughly 5% of those affected might experience progress to CBP.
With epididymitis, the causes come down to STDs, trauma, urine in the epididymitis, and other infections. Prostate infection or bacteria impacting the urinary tract could spread from its initial spot and get to the epididymis. Other viral infections could also lead to this kind of problem.
Research shows that the spread of urethral pathogens could be the mechanism of infection of the epididymis and prostate. Sexually transmitted organisms are the primary trigger for epididymitis. Even if some reports indicate that the same organisms can also lead to prostatitis, more research is necessary to evaluate both of these conditions.
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What Are The Differences Between Prostatitis And Epididymitis
Wondering how to tell the difference between epididymitis and prostatitis? Prostatitis is an ailment of the prostate gland, whereas epididymitis is an inflamed coiled tube . To get a proper epididymitis diagnosis, the doctor can suggest an ultrasound, blood and urine test, and STI screening.
In prostatitis, you may need to do a blood and urine test. But, you will also need a digital rectal exam and a prostate specimen test. A prostatic secretion is used to test for signs of bacterial infection or inflammation. Experts will use a prostatic massage to extract these secretions for adequate treatment and diagnosis.
What Is The Treatment For Epididymitis
The health care practitioner likely will treat the individual with antibiotics through an IV, a shot, or pills orally . Often the treatment depends on the identity of the infecting bacteria many physicians elect to treat with at least two different antibiotics because individuals are occasionally infected with more than one organism.
In men younger than 39 years of age:
- Ceftriaxone : As a single dose either in an IM shot or through an IV line and 1 dose of azithromycin
- Doxycycline : Pills twice a day for 10 days in addition to the shot of ceftriaxone
- The CDC guidelines recommend ceftriaxone 250 IM in a single dose plus doxycycline 100 mg orally twice a day for 10 days or azithromycin 1.0 gram orally all at once to treat chlamydia and gonnorhea.
In men older than 39 years of age or those who participate in anal intercourse :
- Ciprofloxacin : Pills twice a day for 10-14 days
- Sulfamethoxazole and trimethoprim : Pills twice a day for 10-14 days
The CDC guidelines recommend that for acute epididymitis most likely caused by enteric organisms or with negative gonococcal culture or PCR nucleic acid amplification test, treat with the following:
- Levofloxacin 500 mg orally once daily for 10 days.
For patients with non-infectious causes of epididymitis anti-inflammatory medication is often prescribed occasionally, consultation with a urologist is recommended for additional treatments.
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Antibiotic Therapy For Epididymitis
Jeffrey A. Kyle, PharmD, BCPSAssociate Professor of Pharmacy PracticeSamford UniversityBirmingham, Alabama
US Pharm. 2015 40:39-43.
ABSTRACT: Epididymitis, an inflammation of the tube found posterior to the testicle, accounts for a significant number of physician office visits annually. Men diagnosed with epididymitis are typically between the ages of 18 and 35 years and present with a gradual onset of scrotal pain as well as symptoms mimicking urinary tract infection. While the condition is often a result of sexual activity, other risk factors may include prolonged sitting, bicycle or motorcycle riding, prostatic obstruction, and certain medications. Empirical antibiotic therapy should cover Chlamydia trachomatis, Neisseria gonorrhoeae, and Escherichia coli, the most common infecting pathogens. Pharmacists may provide consultation on appropriate antibiotic therapy and dosing.
Genitourinary issues account for a significant number of visits to outpatient primary care offices and emergency rooms each year. Of these conditions, epididymitisinflammation of the epididymis constitutes more than 600,000 diagnoses of men between the ages of 18 and 35 years annually in the United States.1,2 Although no established measure has been documented, the socioeconomic impact of epididymitis is suggested to be substantial given that this condition often occurs during a mans most productive years of life.3
