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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]
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 ...
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.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic or perineal pain without evidence of urinary tract infection, [8] lasting longer than 3 months, [9] as the key symptom. Symptoms may wax and wane. Pain can range from mild to debilitating. Pain may radiate to the back and rectum, making sitting uncomfortable.
Chronic testicular pain may be caused by injury, infection, surgery, cancer, varicocele, or testicular torsion, and is a possible complication after vasectomy. [2] IgG4-related disease is a more recently identified cause of chronic orchialgia. [4] One author describes the syndromes of chronic testicular pain thus:
Side effects may only last for a short time and then go away. Side effects can be relieved in some cases with non pharmacological treatment. [4] Some side effects require treatment to correct potentially serious and sometimes fatal reactions to penicillin. Penicillin has not been found to cause birth defects. [5]
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.
Pain in this region of the body can be associated with anxiety, depression and other psycho-social factors. In addition, this pain can have effects on activities of daily living or quality of life. Treatment can be symptomatic if the pathology is unknown and managed by physical therapy, counseling and medication. [1]