Why is epididymitis getting more painful?

Written by Wang Shuai
Urology
Updated on September 15, 2024
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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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Written by Wang Shuai
Urology
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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.

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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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Symptoms of epididymitis

The main symptoms of epididymitis include enlargement of the epididymis, accompanied by noticeable pain. The skin of the scrotum will appear red and swollen, and touching the scrotum will reveal an increase in local skin temperature. If not treated in time, an epididymal abscess may develop, causing a palpable fluctuation when touching the epididymis. If not addressed promptly, the abscess may rupture, leading to the leakage of pus from the scrotum. If epididymitis is diagnosed, it is important to seek timely treatment at a hospital's urology department. Diagnosis is typically confirmed via ultrasound and a local physical examination, and prompt treatment with antibiotics is necessary. If an abscess has already formed, surgical incision and drainage may be required. (Specific medications should be used under the guidance of a doctor, and self-medication should be avoided.)

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Urology
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How can an epididymal nodule be eliminated?

A significant portion of patients with epididymitis will have a hard nodule left at the site of the epididymis after inflammation control. This nodule is difficult to eliminate through medication. If the patient does not experience discomfort later on, local heat application or massage can be used to help dissipate the nodule. If the nodule does not cause any particular symptoms, no special treatment is needed. However, if the nodule is associated with significant pain or causes recurrent epididymitis, surgical removal of the epididymal nodule is recommended. After the surgery, timely anti-inflammatory treatment should be administered, and the wound should be kept clean and dry. Generally, recovery can be expected in about a week.

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Written by Wang Shuai
Urology
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Is epididymitis serious?

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.