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Epididymitis is a medical condition characterized by inflammation of the epididymis, a curved structure at the back of the testicle. [1] Onset of pain is typically over a day or two. [1] The pain may improve with raising the testicle. [1] Other symptoms may include swelling of the testicle, burning with urination, or frequent urination. [1]
Chronic scrotal pain (pain for greater than 3 months) may occur due to a number of underlying conditions. [3] It occurs in 15-19% of men post vasectomy, due to infections such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele, spermatocele, polyarteritis nodosa, testicular torsion, previous surgery and trauma. [3]
In addition to pain, symptoms also include swelling, abdominal pain, nausea, vomiting, and a testicle in an unusual position—higher than normal or at an unusual angle—according to the Mayo Clinic.
In most cases where orchitis is caused by epididymitis, treatment is an oral antibiotic such as cefalexin or ciprofloxacin until infection clears up. In both causes non-steroidal anti-inflammatory drugs such as naproxen or ibuprofen are recommended to relieve pain.
The human male genitals consist of testicles and epididymides, ductus deferentes, seminal vesicles and ejaculatory ducts, prostate, bulbourethral glands, and penis. [ 1 ] Classification by type of disease
According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. [4] Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency and must be relieved within 6 hours.
Epididymotomy is the placing of an incision into the epididymis and is sometimes considered as a treatment option for acute suppurating epididymitis. Epididymectomy is the surgical removal of the epididymis sometimes performed for post-vasectomy pain syndrome and for refractory cases of epididymitis.
About 40% of people require removal of the testicle. [2] It is most common just after birth and during puberty. [2] It occurs in about 1 in 4,000 to 1 in 25,000 males under 25 years of age each year. [2] [3] Of children with testicular pain of rapid onset, testicular torsion is the cause of about 10% of cases. [2]