Epididymitis is inflammation of the epididymis, the conduit connecting the testicle to the prostate. It is often caused by a sexually transmitted infection (STI) but can have other causes as well.

By definition, epididymitis is inflammation of the epididymis. Conduit connecting the testis to the prostate, the epididymis is an essential structure of the male reproductive system. Although there are two epididymis, an acute epididymitis usually affects only one.

While chronic epididymitis can set in, the most common form is acute epididymitis.

It is not uncommon for epididymitis to be associated with other infections such as:

• urinary tract infection, which can for example be manifested by urethritis, inflammation of the urethra, the outlet duct of the bladder;
• prostate infection, which is manifested by prostatitis, inflammation of the prostate;
• infection of the testicles, which manifests as orchitis, inflammation of the testes, or orchi-epididymitis, a combination of orchitis and epididymitis.

Epididymitis is usually infectious in origin. It may be due to:

• a sexually transmitted infection (STI) such as chlamydia, which is caused by the bacteria Chlamydia trachomatis, and gonorrhea, which is caused by the bacteria Neisseria gonorrhoeae ;
• a urinary tract infection, especially during an infection with Staphylococcus aureus ;
• prostate infection, manifested by prostatitis, which can be the consequence of a benign prostatic hypertrophy, a medical examination or even a surgical intervention on the prostate.

In some rare cases, epididymitis can also be caused by tuberculosis.

Only men can be affected by epididymitis because the epididymis is a structure specific to the male reproductive system.

This inflammation manifests itself mainly in:

• the young man who is affected by a sexually transmitted disease (STD);
• the old man who has prostate disease or has a urethral catheter.

Without adequate medical treatment, acute epididymitis can progress, become chronic and lead to complications. This inflammation can lead to:

• the formation of a epididymal or testicular abscess ;
• a testicular ischemia which may cause infarction, necrosis or testicular atrophy;
• a infertility.

An epididymitis can manifest itself by several symptoms such as:

• high fever, usually over 38,5 ° C and accompanied by chills;
• sudden, intense pain radiating down the spermatic cord;
• swelling of the epididymis, which becomes painful on palpation;
• inflammatory signs in the scrotum which give it a red, edematous, shiny and hot appearance.

Epididymitis should be treated as soon as possible to limit the risk of complications.

Treatment of epididymitis is usually based on antibiotic therapy. The choice of antibiotics depends on the germs responsible for the infection. Before the precise identification of these infectious agents, broad-spectrum antibiotic therapy is often implemented. It is then adapted to specifically target the pathogenic germs responsible for epididymitis. It can also be supplemented by anti-inflammatory treatment.

During the first days of treatment, a bed rest phase is recommended. The patient may also be advised to wear a testicular suspender or tight briefs.

Drug treatment for epididymitis usually lasts between 2 and 3 weeks. It can be prolonged for more than a month in severe forms. In some rare cases, surgery may be necessary.

As a precaution, the diagnosis of epididymitis involves:

• abstaining from sex or wearing condoms until healing is complete;
• screening and treatment of the partner (s);

carrying out screening tests for different STIs.