Epididymitis is a very unpleasant condition associated with severe pain. It affects a male organ known as epididymis, which is located in the scrotum above each of both testes. Epididymis serves to store sperm cells and release them during ejaculation.
The most common cause of an epididymitis is bacterial affection that starts as a urinary tract infection. Subsequently, the bacteria spread to the epididymis. Relatively common causes in younger men are sexually transmitted diseases such as chlamydia infection and gonorrhea. Increased risk of epididymitis is reported in patients after bladder catheterization and after prostate surgery.
Acute infectious epididymitis manifests with pain, redness and swelling of the scrotum, which asymmetrically enlarges. At first glance, it seems like an enlarged testicle. Fever, painful scrotum (on touch) and pain during ejaculation are usually also present.
Any patient with enlarged painful scrotum should be examined by a urologist. In addition to physical examination, the doctor usually indicates an ultrasound of the scrotum to rule out other condition, especially the testicular torsion. Urinalysis including microbiological examination of urine may be beneficial when the epididymitis follows a urinary tract infection.