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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]
In most cases where orchitis is caused by epididymitis, treatment is an oral antibiotic such as cefalexin or ciprofloxacin until the infection clears up. In both causes non-steroidal anti-inflammatory drugs such as naproxen or ibuprofen are recommended to relieve pain.
The exact cause of an epididymal cyst is unknown, but it is most likely a congenital anomaly associated with hormonal imbalances during embryonic life. [3] Previous research has shown a correlation between the development of epididymal cysts and maternal exposure to endocrine disrupting substances like diethylstilbestrol during male fetal development.
Chronic infectious epididymitis is rare. [13] Some signs and symptoms include localized tenderness and swelling in the epididymis, which are different from any tenderness/abnormality present in the testis, these are usually not found in lower urinary tract. Chronic infectious epididymitis may be diagnosed in healthy adolescents as well as men.
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...
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.
Epididymectomy is the surgical removal of the epididymis sometimes performed for post-vasectomy pain syndrome and for refractory cases of epididymitis. Epididymectomy is also performed for sterilization on some male animals of livestock species so they can be used to detect estrus in females ready for artificial insemination.
[1] [2] [3] Because this condition is a syndrome, there is no single treatment method, therefore efforts focus on mitigating/relieving the individual patient's specific pain. [ 1 ] [ 2 ] [ 4 ] [ 5 ] When pain in the epididymides is the primary symptom, post-vasectomy pain syndrome is often described as congestive epididymitis .