Is epididymitis serious?

Written by Wang Shuai
Urology
Updated on September 16, 2024
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Whether epididymitis is severe depends on the patient's condition. If it is an early case of epididymitis, the epididymis may just be enlarged and painful, which is not very serious. Generally, using antibiotics and regular treatment, it can heal in about 1 to 2 weeks.

However, if treatment is not administered in time, leading to abscesses in the epididymis and testicle, or even rupture of the abscesses, the situation is relatively severe. It requires immediate surgical intervention to drain the abscess. The prognosis thereafter is relatively poor, and it can easily lead to the possibility of testicular atrophy. Therefore, epididymitis should be treated promptly.

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Written by Wang Shuai
Urology
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Does epididymitis require the removal of the testicle?

After developing epididymitis, in most cases, it is not necessary to remove the testicle. The appearance of epididymitis is mainly due to an infection by pathogens that causes the epididymis to become enlarged and painful. With early and timely anti-inflammatory treatment, generally, medication can lead to cure after one to two weeks for most patients, so surgical intervention is usually not necessary. If epididymitis is not treated promptly, it is very likely to cause inflammation of the testicle, and even lead to abscesses in the epididymis and testicle. In severe cases, it might become necessary to remove the testicle. Therefore, after developing epididymitis, one should promptly visit the urology department of a hospital for standard treatment to avoid unnecessary complications. (The use of medications should be under the guidance of a doctor.)

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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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How to treat epididymitis?

For the treatment of epididymitis, antibiotics are mainly used. Epididymitis is mostly caused by bacterial infections, such as Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. In such cases, it is necessary to use fluoroquinolone antibiotics and cephalosporin antibiotics promptly. If it is caused by a viral infection, antiviral medications are recommended. During treatment, it is important to eat a light diet and avoid spicy and irritating foods. Smoking and alcohol should be avoided. Patients should lie down as much as possible, rest, and elevate the scrotum, which helps the circulation of blood in the scrotum and testicles and aids in the improvement of the condition. Vigorous exercise or prolonged standing during treatment can worsen the condition. (The use of medications should be guided by a professional doctor.)

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Urology
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epididymitis symptoms

The main clinical manifestations of epididymitis are significant enlargement of the epididymis accompanied by obvious pain. At the same time, the skin of the scrotum will be red and swollen, and the skin temperature will increase. If not treated promptly, the condition may further develop and possibly involve inflammation of the testis, and even lead to the possibility of testicular and epididymal abscesses. If a testicular or epididymal abscess occurs, touching the testis and epididymis will show a distinct fluctuation, and even an abscess rupture may occur, with pus visible on the skin of the scrotum and flowing out from within the scrotum. If these symptoms appear, it is necessary to promptly visit the hospital's urology department and use antibiotics for standard treatment. If an abscess has already formed, an abscess incision and drainage should be performed. (Specific medication use should be carried out under the guidance of a doctor.)

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What should I do if I have an epididymal nodule?

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.