1. Is the epididymis a testicle?
The epididymis is not a testicle. In the male scrotum, there are two testicles that look like pigeon eggs, and their function is to produce sperm and synthesize androgens. The epididymis surrounds and sits immediately above the testicles, with the enlarged upper part called the head of the epididymis and the thin, pointed lower part called the tail of the epididymis (see picture below). Its main function is as a place for sperm maturation and also for sperm storage. Therefore, the epididymis plays an important role in male reproductive physiology.
2.How does epididymitis occur?
Since the tail of the epididymis is connected to the vas deferens and opens to the prostate gland and the posterior urethra, the urethra is connected to the outside world. Therefore, various microorganisms or bacteria can return from the urine to the vas deferens causing epididymitis. It is also possible for bacteria to stay in the epididymis through the transmission of blood and multiply thus leading to the development of epididymitis. However, the probability of occurrence of this kind of blood transmission infection is relatively small.
3.What are the pathogens that cause epididymitis?
Epididymitis is mainly caused by bacteria, viruses, etc. There are also some pathogenic microorganisms or parasites of unknown etiology. Common bacteria include E. coli, Staphylococcus, Mycobacterium tuberculosis, Gonococcus and Chlamydia.
4.What are the types of epididymitis?
Epididymitis can be divided into two types, acute epididymitis and chronic epididymitis, according to the characteristics and symptoms of the disease.
5.At which age is epididymitis mainly found?
Epididymitis is a common disease of the male reproductive system, and can occur at any age, from infants to the elderly, with peak incidence between the ages of 19-35, when men are sexually active.
6. Can frequent masturbation cause epididymitis?
It is possible, but not common. This is because frequent masturbation can cause repeated congestion of the prostate gland, and if you don’t pay attention to hygiene, it is easy for bacteria or microorganisms to enter the urethra. Frequent masturbation can cause the urine with bacteria to reflux, thus causing male diseases such as epididymitis or prostatitis.
7.What are the symptoms of acute epididymitis?
Acute epididymitis usually develops rapidly, with obvious pain and swelling of the scrotum, redness of the scrotal skin, and pain radiating to other parts such as the groin and lower abdomen. The pain increases when standing or walking and is often accompanied by an increase in body temperature. It may be accompanied by symptoms of frequent and urgent urination.
8.Is chronic epididymitis transformed from acute epididymitis?
Chronic epididymitis is more common in clinical practice. It is generally believed that chronic epididymitis may turn into chronic due to failure to get thorough treatment during the acute period, but some patients often have no history of acute attacks before that; some patients are often accompanied by chronic prostatitis, which may be caused by the spread of inflammation of chronic prostatitis or the reflux of urine with bacteria.
9.What are the symptoms of chronic epididymitis?
The symptoms of chronic epididymitis vary widely. Patients may experience pain and discomfort in the lower abdomen, groin or scrotum, either unilaterally or bilaterally at the same time. The pain varies from person to person, from mild discomfort to significant scrotal pain. There is often an irregular history of painful swelling of the epididymis. When touching the epididymis, it can be found that the epididymis is mildly enlarged and hardened, with mild pressure pain, and some can find swollen nodules.
10.Does epididymitis affect the testicles?
Epididymitis can spread directly to the testicles causing orchitis, and the testicles will also appear swollen and obvious pain to the touch. When the inflammation of epididymis and testis is serious, it will affect the blood supply of testis, resulting in testis ischemia and hypoxia, metabolites cannot be discharged in time, and testis damage, which may even cause testis sperm production function to decrease and testis atrophy in serious cases.
11.What tests do I need to do if I have epididymitis?
The clinical manifestations of epididymitis are relatively obvious, and it is generally not difficult to distinguish them when combined with careful physical examination. However, urine routine and scrotal ultrasound examination are usually needed to make a clear diagnosis and exclude other similar diseases such as testicular torsion, testicular trauma and prostatitis.
12. Acute epididymitis and testicular torsion have similar symptoms, how to distinguish them?
Acute epididymitis is most likely to be confused with testicular torsion, both of which are intra-scrotal emergencies with similar clinical manifestations but very different treatment methods. Acute epididymitis mainly manifests as scrotal swelling and pain, redness of scrotal skin, some symptoms such as frequent and urgent urination and elevated body temperature. Testicular torsion is mostly seen in adolescents. Testicular spermatogenesis is impaired in 2 hours of testicular torsion, and the testicle will be necrotic after 6 hours. The main clinical manifestations of testicular torsion are scrotal pain and scrotal enlargement, but the body temperature usually does not rise. The difference between the two is mainly in the physical examination. In epididymitis, the physical examination will reveal an obviously enlarged epididymis with tenderness, and the testicles are sometimes enlarged. The pain is relieved when the scrotum is lifted and elevated. The testicular reflex is present. In contrast, testicular torsion has an abnormal testicular position on examination, pressure pain is obvious, the testicular reflex disappears, and the pain does not decrease when the scrotum is lifted and elevated. When it is difficult to distinguish between the two, ultrasound examination of scrotum can be done to differentiate.
13.How can chronic epididymitis be distinguished from chronic prostatitis?
The symptoms of chronic epididymitis and chronic prostatitis are similar, both of them have a long course of disease and may cause pain and discomfort in the scrotum, lower abdomen and groin, and the pain symptoms may be mild or severe. The two are easy to distinguish despite their similar clinical presentation. The physical examination of chronic epididymitis can show enlargement or nodules in the head or tail of the epididymis, while the testicular epididymis of chronic prostatitis is generally normal in size and shape, but the prostate fluid examination is often positive. In addition, the ultrasound examination of the urinary tract can be differentiated.
14.Is epididymitis easily cured?
If acute epididymitis is not treated in time at an early stage, it will not only not relieve the patient’s pain, but will also delay the disease and make the treatment effect much less effective. Therefore, if the symptoms of suspected epididymitis appear, you should go to the hospital in time for emergency treatment, and do not self-diagnose and take medicine casually. In short, the treatment of epididymitis is not complicated, but it needs to be taken seriously, and early diagnosis and treatment is the key.
15.How to treat epididymitis?
The general treatment of epididymitis includes bed rest, elevating the scrotum to reduce the feeling of swelling, prohibiting physical activity and sexual life, and applying cold compresses with ice packs at the early stage of the disease. The antimicrobial treatment of epididymitis should first be based on bacterial culture and drug sensitivity test to select suitable antimicrobial drugs, such as quinolones can be used temporarily when the test results are not yet available, and the decision will be made after the drug sensitivity results are available. If the symptoms of acute epididymitis are severe in the early stage of development, lidocaine plus dexamethasone can be used for closure treatment, which can relieve the symptoms in a short time and promote the absorption of inflammatory masses. Surgery is required in a few cases, such as epididymitis that does not improve or worsen after general treatment; testicular or scrotal wall abscess that requires incision and drainage to reduce pressure; testicles and epididymis with severe ischemic and hypoxic symptoms due to inflammation spreading, which may affect function, surgery can be considered.
16.Does epididymitis require surgery?
Epididymitis generally does not require surgery, and conventional antibacterial medication and symptomatic treatment are sufficient. However, in a few cases, surgery should be considered as appropriate. For example, internal treatment is ineffective and the condition persists; severe scrotal pain, high fever, pus in the epididymis in the scrotum; serious blood flow disorders in the epididymis and spermatic cord, etc.
17.How to judge whether epididymitis is cured or not?
If the symptoms of epididymitis disappear after standard treatment, such as the enlarged epididymis shrinks to normal size, the pain disappears, the body temperature is normal and the blood picture is normal, it can be considered as cured. This treatment process should be maintained for at least 2 weeks. If the symptoms do not disappear completely, the treatment period should be extended as appropriate.
18.Does epididymitis recur after it is cured?
The blood supply of the epididymis is rich, and drugs can easily reach the lesion. If sensitive antibacterial drugs are selected for treatment, combined with bed rest, elevation of scrotum and other general treatment, the treatment of epididymitis is not difficult. It is also generally not recurring after the epididymitis is cured, but early and standardized treatment is needed.
19.Can I have sexual life if I have epididymitis?
In the acute stage of epididymitis, all sexual activities should be prohibited and the amount of activities should be reduced; in the chronic stage, sex should be avoided as much as possible when the symptoms are serious, but if the symptoms are mild, you can have sex occasionally, but it is better to wait for the condition to heal before having sex. Because the sexual organs will be congested with blood during sexual impulses, if there is inflammation at this time, it is easy to cause the spread of inflammation, thus making it difficult to heal the inflammation.
20.How long can I have sex after epididymitis is cured?
There is no strict deadline for how long you can have sex after epididymitis is cured. Acute epididymitis prohibits sexual life and can be carried out after complete cure; chronic epididymitis generally discourages sexual life during standard treatment, but some chronic epididymitis can have sexual life without clear pathogenic bacteria infection, but it should not be too frequent.
21.What is the hard knot caused by epididymitis?
After the treatment of epididymitis, some people may feel small hard nodules in the epididymal duct [please add why this happens, this is a very common situation, some research studies say that about 50-70% of patients will appear. These nodules are formed by the chronic inflammatory reaction and fibrous tissue proliferation in the epididymal duct. After the treatment of epididymitis is healed, some of these nodules may be absorbed and disappear, while some may still remain. In general, this kind of hard nodes will not have much effect on the body. If there is obvious swelling and pain or if it affects fertility, you should go to the hospital and have surgery.
22.What about testicular atrophy caused by epididymitis?
Epididymitis is very harmful, and one of the biggest hazards is that it may cause testicular atrophy, which will affect fertility and lead to male infertility. If testicular atrophy is caused, it means that the testicular tissue on that side has been severely damaged and the spermatogenic tubules are atrophied, so the spermatogenic function of that side of the testicle is generally difficult to recover and the treatment is not effective. Therefore, we should be alert to the occurrence of such complications, when there is acute testicular pain, you should seek medical attention in time, early diagnosis and treatment is the key.
23.Will epididymitis become epididymal cancer if left untreated?
The incidence of primary epididymal cancer is extremely low, and the pathogenesis is still unclear. There are very few reports on epididymal cancer worldwide, so there is no systematic research on epididymal cancer in the world. Epididymal cancer has a rapid progression and a high degree of malignancy. There is no study showing an association between epididymitis and the occurrence of epididymal cancer. However, if epididymitis is not treated, the severe scrotum often seriously affects the patient’s quality of life, and secondly, it can spread to the testicles, causing inflammation of the epididymal testicles and damage to the testicles. In addition, if it turns into chronic epididymitis, it can affect the health of patients for a long time. Therefore, it is recommended that once there is pain in the scrotal area, treatment measures should be taken in time.
24.Will epididymitis get better on its own without medication?
If epididymitis is not treated, it is difficult to be cured only by one’s own resistance, and the inflammation may even cause the loss of testicular epididymis function when it is serious. The actual fact is that you should go to a regular hospital in time to get treatment if you are suffering from epididymitis, so don’t miss out on your condition.
25.Does epididymitis have any effect on fertility?
Generally speaking, if epididymitis is treated properly, it will not affect fertility. However, in a few cases where the inflammation is serious, the epididymis can be blocked by the inflammation of both epididymis, which can cause the sperm to be difficult to be discharged and cause infertility. In this case, you should go to a hospital to undergo an unblocking operation to restore your fertility.
26.Does epididymitis affect the quality of semen?
Epididymitis can reduce the quality of semen. If inflammation occurs in the epididymis, it will affect the environment for sperm survival, reduce the vitality of sperm in semen, and increase the rate of malformation.
27.Is the round lump felt on the epididymis the hard node left by acute epididymitis?
Not necessarily. If it is a residual hard node after epididymitis treatment, then there must be a history of epididymitis before. If there is no history of epididymitis, but a round lump can be felt in the epididymis, then it is likely to be an epididymal cyst. If there is a history of tuberculosis, it is possible to feel bunches of round lumps, which should be epididymal tuberculosis.
28.If I have epididymitis, what should I pay attention to in terms of diet?
Generally speaking, there is no need to avoid eating too much and a balanced diet is sufficient, but it is not advisable to eat too much greasy food, avoid spicy, smoking and alcohol.
29.How to effectively prevent epididymitis?
Epididymitis is one of the common diseases of male reproductive system, we should do the following measures to prevent the occurrence of such diseases.
(1) Sexual life should not be too frequent. A moderate sex life can bring benefits, but if indulgence is not controlled, it will make the reproductive organs congested for a long time, which will easily cause various male reproductive diseases.
(2) Avoid unclean sexual intercourse. Many male reproductive diseases occur with unclean or unprotected intercourse. Unclean intercourse is not only easy to make yourself sick, but also infected to your wife, which is extremely harmful.
(3) pay attention to sexual organ hygiene. Both men and women should pay attention to cleanliness and hygiene during sex, such as cleaning the foreskin, pay attention to menstrual hygiene.
(4) Learn the general knowledge of sexual physiology.