One of the most predominant causes of testicular pain is Epididymitis, a swelling of the tube connecting the seminal tubules to the vas deferens. The epididymis collects sperm produced in the seminal tubules and its lower end acts as a collecting vesicle until ejaculation occurs when the muscular contractions of the vas deferens transport the sperm. For epididymitis to occur, there has usually been a prolonged, untreated, urinary tract infection that has preceeded it.
Take this very common scenario. A sexually active, middle aged male comes to the emergency room presenting with right testicular pain. He also mentions that urination is painful and that he has noticed a rather grey liquid drips from the tip of his penis and that the discharge has wet and stained his underwear.
Upon physical examination, the emergency room physician notices that the testicle is swollen in the area of the epididymis and that the patient is running a slight fever. The fever and the discharge indicate an infection is brewing and the physician is strongly suspicious of Gonorrhoea. A swab of the discharge and a urine sample are sent to the lab to confirm the presence of gonococci – round shaped bacteria responsible for Gonorrhoea.
At this point the patient is treated with an intramuscular injection of 250mg of Rocephin. NSAIDS such as Ibuprofen help deal with the pain and inflammation.
A copy of the patient’s lab results are also delivered to the County Health Dept where follow up is directed to determine a list of contact people that could have been a source of the STD and also could have contracted the STD.
Chlamydia is another frequent cause of Epididymitis. It is characterized by a clear, watery emission. Again a lab culture will support this. Traditionally, Chlamydia is treated with a 1 gram dose of Zithromax taken by mouth in the ER or physician’s office. As with all types of STDs, results are conveyed to the Health Dept. where a contact list will be produced and followed up on.
In younger men, epididymitis can also be caused by a five tailed protozoan called Trichomonas vaginalis. It is transmitted from an infected female. In females there is a characteristic greenish grey discharge; however, in males 50% are asymptomatic. The World Health Organization estimates that 180 million new cases occur each year and in North America 5-8 million new cases arise. Condoms will significantly reduce contraction of this STD but it is not 100% fool proof.
Usual treatment is 750mg of Flagyl taken twice a day for one week. Patient adherence for the whole week is imperative to prevent the return of the more persistent, hardy strains.
Epididymitis in senior men is traditionally caused by a prolonged infection of a bacteria called E. coli. In these cases the patient is prescribed Bactrim or Cipro tablets taken twice a day for 2 weeks. Again, compliance is extremely important.
Should you wish to learn more about Epididymitis and other male urological problems, you may click on the link below that will take you to a secure ordering site for my book, “Comprehensive Guide To Undertanding Testicular Pain and Other Sensitive Male Issues”.
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After 37 years of medical practice in family practice and emergency room medicine, Dr Keats has immeasurable information to give you concerning men’s health issues such as epididymitis, testicle pain, STDs. We highly recommend Dr Keats website to learn more about epididymitis, testicle pain, STDs.