What should I do if I have an epididymal nodule?

Written by Wang Shuai
Urology
Updated on September 13, 2024
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Many patients who have suffered from epididymitis will have a hard, smooth-surfaced, slightly tender, or asymptomatic nodule left on the epididymis after the swelling subsides and pain is controlled. This type of nodule is also referred to as a negative nodule. These nodules are difficult to completely eliminate with antibiotics, or may not be eliminated at all.

If the patient does not have significant discomfort, no special treatment is necessary. If the presence of the nodule leads to recurrent inflammation or significant pain, affecting the patient's normal work and life, it may be considered to apply local heat or gently massage to promote the reduction of the nodule. If these treatments do not effectively improve the condition, it is recommended to surgically remove the nodule from the epididymis.

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Written by Wang Shuai
Urology
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How is epididymitis caused?

Epididymitis refers to the inflammation of the epididymis, characterized by enlargement and pain, caused by infections from pathogens such as bacteria. The main cause of epididymitis is usually a preceding infection such as urethritis, bacterial prostatitis, or vesiculitis that was not timely treated. Bacteria spread along the vas deferens to the epididymis, leading to epididymitis. Additionally, trauma to the epididymis can also cause epididymitis. Another common scenario is related to certain medical procedures, such as prolonged catheterization or after undergoing plasma electrocautery surgery of the prostate, which can easily lead to epididymitis. Once epididymitis occurs, it is crucial to promptly treat it with antibiotics. During treatment, it is advisable to consume a light diet, avoid spicy and stimulating food, rest as much as possible in bed, and keep the scrotum elevated. (Specific medication usage should be conducted under the guidance of a doctor.)

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Urology
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Is bed rest necessary for epididymitis?

After the occurrence of epididymitis, the epididymis will enlarge to various extents, accompanied by pain, and the weight of the epididymis will significantly increase. In such cases, if the patient stands or sits for extended periods, the pain becomes more noticeable and is not conducive to treating the condition. Frequent prolonged sitting or standing, or even intense physical activity, could potentially lead to the risk of testicular torsion. Therefore, after being diagnosed with epididymitis, doctors usually advise patients to lie flat as much as possible. It is best to elevate the scrotum while lying flat, as this helps with local blood circulation and positively affects the treatment of the condition. If there is a need for special circumstances requiring some activity, it is best to use a scrotal support to lift the scrotum.

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Urology
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Why is epididymitis getting more painful?

After suffering from epididymitis, the epididymis will show symptoms of enlargement and pain. If not treated promptly, the epididymis will further enlarge, and the pain will gradually become more pronounced, which is a normal phenomenon. However, if the pain continues to worsen despite active treatment, it should be considered that this may be due to a lack of attention to lifestyle care, such as engaging in vigorous exercise during treatment, or situations involving prolonged standing or sitting. Additionally, it is important to be vigilant about the possibility of testicular torsion accompanying epididymitis. Therefore, if the pain continues to worsen during the treatment of epididymitis, it is advisable to promptly re-examine the color Doppler ultrasound to understand the blood flow situation of the testicles and epididymis, and then proceed with targeted treatment.

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Urology
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What causes epididymitis?

The occurrence of epididymitis is primarily due to the inflammatory reaction caused by pathogenic microbial infections of the epididymis, with common pathogens including Escherichia coli, Staphylococcus, and Pseudomonas aeruginosa. This is mainly due to previous conditions such as urethritis, bacterial prostatitis, and vesiculitis not being timely treated, allowing the pathogenic microbes to gradually spread along the vas deferens to the epididymis, leading to inflammation. Epididymitis may also occur due to prolonged use of urinary catheters or post-prostate resection surgery. After the onset of epididymitis, the epididymis will exhibit symptoms of enlargement and pain. It is necessary to promptly use antibiotics for treatment. During the treatment period, attention should be paid to a light diet; avoid spicy and irritating foods, lie flat as much as possible, and elevate the scrotum. (Please use medications under the guidance of a doctor)

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Epididymitis Symptoms and Treatment Methods

Epididymitis refers to the enlargement of the epididymis caused by infections such as bacteria and viruses, accompanied by pain. Some patients may notice swelling of the scrotal skin and even an increase in skin temperature. For this condition, it is necessary to use antibiotics in a timely manner. If the epididymitis is caused by bacterial infection, quinolone antibiotics or cephalosporin antibiotics can be used for treatment, generally requiring medication for one to two weeks. If the symptoms are severe, it is advisable to administer antibiotics intravenously for better results. If it is caused by a viral infection, antiviral medications are needed. During treatment, it is important to rest in bed as much as possible and to keep the scrotum elevated to facilitate local blood circulation. Dietary considerations should include eating lighter foods and avoiding spicy and irritating foods. (The use of medication should be under the guidance of a doctor.)