Epididymitis/Orchitis

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Treatment

Treatment for epididymitis and epididymo-orchitis involves treating the underlying cause, if possible, such as using antibiotics to treat bacterial infections and treating urinary blockage (e.g., enlarged prostate treatment). Common side effects of antibiotics include upset stomach and diarrhea.

When a sexually transmitted infection is the cause, recurrence can be prevented if the sexual partner is also treated, even if the partner does not have symptoms. Treatment for mumps orchitis and trauma-related epididymitis is limited to managing symptoms. If the drug amiodarone is the cause, the inflammation usually goes away after the drug is discontinued.

Pain and inflammation may be treated with nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., aspirin, ibuprofen), rest, ice, elevation, and wearing scrotal support. Lying down with the scrotum elevated above heart level, by placing a rolled towel under the scrotum, may help to relieve pain and swelling and can promote healing.

Drinking plenty of water can also help speed recovery from infection. NSAIDs can cause stomach pain, ulcers, and rarely, kidney problems. Chronic pain may be treated with specialized pain management methods.

Surgery may be needed in severe cases with complications (e.g., abscess, death of a testicle). Also, chronic epididymitis is sometimes resolved with surgical removal of the epididymis. Tuberculous epididymitis might resolve with TB treatment, but damage can be severe and may require surgical removal of the testicle and/or epididymis.

Surgical removal of the epididymis or testicle leads to loss of sperm production on the affected side. If both testicles or both epididymes are removed, infertility results. Surgical complications include damage to nearby structures, which may cause fertility problems or pain.

With treatment, most acute cases improve within a few days. If not, a doctor should be contacted. Complete relief of symptoms may take weeks or months. For example, TB cases that are treated with medications take months for treatment and complete recovery. After the prescribed treatment is completed, patients should follow up with the doctor. Chronic cases usually require ongoing treatment for symptoms.

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