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who have had a bladder . In boys before , Epididymitis is an infection or of epididymitis may be associated with abnormalities of the the , a structure that carries from () or (bladder the testicles. Epididymitis can be a sexually trans- and kidneys). mitted disease, but not always. The main symp- toms are pain and swelling of the (the What are some possible sac containing the testicles). It is important to get medical help for this condition. Rest and antibio- complications of epididymitis? tics are the usual treatments.  With proper treatment, complications are uncommon.  Without treatment, the infection may spread. This can cause damage to the reproductive organs, possibly includ- What is epididymitis? ing . Epididymitis is a painful condition caused by inflamma- What increases the risk of tion of the epididymis, which carries and stores sperm. It is located in the scrotum next to the . Epididymitis epididymitis? is most common in young men. It may be caused by a -  When epididymitis is from a sexually transmitted dis- ually transmitted infection, although other sources of infec- ease, the main risk factors are having a lot of partners tion are possible. Once epididymitis is recognized, it usually and not using a every time you have sex. improves quickly with and other simple treat- ments.  Bladder and other infections of the reproduc- Epididymitis is uncommon in boys before puberty. In this tive organs may also lead to epididymitis. Other abnorm- age group, swelling of the scrotum is more often caused alities or previous of the reproductive or urinary by a condition called . Immediate treatment organs also increases the risk. is needed—this condition can permanently damage the tes- ticles. Can epididymitis be prevented? ! Boys with pain in the testicles always need prompt medical attention.  Not having sex is the best way to prevent epididymitis and other STDs. If you are sexually active, limit the What does it look like? number of your sex partners.   Pain and swelling of the scrotum, often involving the Use a condom every time you have sex. testicle.  Pain develops over a few days and may be severe. How is epididymitis diagnosed?  There may be redness on the of the scrotum.  Your doctor can usually tell whether epididymitis is pres- ent based on symptoms and a physical examination.  There may be a painful lump (the epididymis) on the affected testicle.  If there is any doubt, an ultrasound examination may be performed. This is done to make sure there isn’t another  Fever may be present. cause of pain and swelling, especially testicular torsion.  Sometimes, pain may occur when your child is urinating  Urinalysis and tests for STDs are done. or fluid may drain from the .  Can look like testicular tortion because of pain and How is epididymitis treated? swelling of the testicle.  Eliminating the infection. What causes epididymitis?  Antibiotics are prescribed. The exact  depends on the identified or most likely cause of the The usual cause is infection with , spreading either infection. from the penis or the bladder. In sexually active boys and men, the main causes are sexually transmitted diseases  Make sure to finish the antibiotic prescription, even if (STDs). The most common causes of infection are the symptoms have gotten better. Stopping treatment too bacteria or . early may allow the infection to come back.  However, epididymitis is not always a sexually transmit-  If the epididymitis is from a STD, sexual partners may ted disease. For example, it can occur in boys or men need to be tested and treated as well.

Copyright 2007 by Elsevier 225 226 n Epididymitis

 Treating pain and swelling. When should I call your office?  Rest.  Call our office if symptoms of epididymitis (swelling of  Support for the scrotum: wear briefs rather than boxer the scrotum, pain of the testicles) do not improve within shorts. a few days, or if they get worse.  Take for pain, such as acetaminophen or  Call our office if symptoms of testicular torsion develop, ! ibuprofen. especially sudden, severe, or increasing pain and tender- ness of the scrotum. This is an emergency!  Pain and swelling usually improve within a few days after the start of treatment. If not, call our office.

Copyright 2007 by Elsevier