Epididymitis Explained: What Every Man Should Know

Epididymitis is a condition that many young and middle-aged men may encounter. It occurs when the body’s resistance is low, allowing pathogenic bacteria such as Escherichia coli, Staphylococcus, and Streptococcus to enter the vas deferens and retrograde into the epididymis, causing inflammation. This condition is often accompanied by urethritis, prostatitis, and seminal vesiculitis. Typically, patients will notice a hardened lump, usually at the head or tail of the epididymis, with the tail being more commonly affected.

Rising Incidence of Epididymitis

Epididymitis is increasingly common among young and middle-aged men, primarily due to a lack of awareness and understanding of the condition. This knowledge gap often leaves men unaware of why they develop epididymitis in the first place. The primary cause of epididymitis is the invasion of pathogenic bacteria into the epididymis, leading to inflammation. The most common culprit is Escherichia coli, followed by Proteus, Staphylococcus, Enterococcus, and Pseudomonas aeruginosa. Additionally, Chlamydia can also be a cause.

Other Causes of Epididymitis

Several other factors can contribute to the development of epididymitis:

1. Non-sterile urine reflux into the ejaculatory duct, leading to chemical epididymitis.

2. Secondary infection from prostatitis or urinary tract infections, where non-sterile urine refluxes into the ejaculatory duct, causing chemical infection. Experts note that urine can also reflux into the seminal vesicles, contributing to the condition.

3. Post-prostatectomy, particularly after transurethral prostatectomy, where bacteria-laden urine may cause retrograde infection due to reflux into the ejaculatory duct, leading to epididymitis.

Symptoms of Epididymitis

Clinically, epididymitis is categorized into acute and chronic types, each presenting distinct symptoms.

Acute Epididymitis Symptoms:

- Sudden high fever and elevated white blood cell count.

- Swelling and pain in the affected scrotum, along with a dragging sensation.

- Pain in the lower abdomen and inguinal area, exacerbated by standing or walking.

- The affected epididymis becomes swollen with obvious tenderness.

- Inflammation may spread, causing both the epididymis and testis to swell, blurring their boundaries—a condition known as epididymo-orchitis.

- The spermatic cord on the affected side may also thicken and become tender.

- Acute symptoms generally subside within a week.

Chronic Epididymitis Symptoms:

- More common than acute epididymitis.

- Often results from incomplete treatment of acute infection or as a secondary condition to chronic prostatitis or injury.

- Patients experience dull pain in the affected scrotum, a feeling of heaviness and dragging.

- Pain may radiate to the lower abdomen and ipsilateral inguinal area.

- Sometimes secondary hydrocele occurs.

- The epididymis may be enlarged and hardened to varying degrees with mild tenderness, and the ipsilateral vas deferens might thicken.

Treatment and Management

The treatment duration for epididymitis is typically long. One effective treatment option is the herbal medicine Diuretic and Anti-inflammatory Pill, which targets both symptoms and the root cause of the condition.

To identify potential epididymitis, consider these self-check methods:

1. During the Acute Phase: Look for symptoms caused by external compression or excessive sexual activity, such as a feeling of the testis being squeezed or ruptured.

2. Hardened Lump: Generally, patients will notice a hardened lump, often at the head or tail of the epididymis.

3. Sudden High Fever: Accompanied by an elevated white blood cell count, swelling and pain in the scrotum, and a dragging sensation in the lower abdomen and inguinal area.

4. Chronic Inflammation: More common, with symptoms such as dull pain in the scrotum, heaviness, dragging sensation, and pain radiating to the lower abdomen and inguinal area.

Preventive Measures

To prevent epididymitis, consider the following measures:

1. Maintain a Regular Lifestyle: Ensure smooth bowel movements and avoid excessive fatigue.

2. Mental Adjustment: Keep a relaxed mood, avoid stress, and engage in physical activities like Qigong and Tai Chi to enhance fitness.

3. Improve Diet: Avoid high-cholesterol foods, opt for more white meat (like chicken and fish), and reduce red meat consumption.

4. Avoid Spicy Foods and Alcohol: These can lead to internal dampness and heat, which should be avoided to prevent urinary difficulties.