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Epididymitis --- Why You Feel Like
You've Been Kicked in the Balls
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June 29, 2015
By Susan Callahan, Contributing Columnist

A lot of men are suffering in silence out there. Epididymitis, the cause
of this pain, is often a chronic, painful condition.

The condition literally means inflammation of the epididymis, the cord-
like structure that lies to the backside of your testicles.  Although there
are no good estimates for the prevalence of this condition, one US
Army study in 1966 reported a revealing fact --- epididymitis was the
Number One most common problem treated by the of men who
reported for treatment by a urologist. That study found that a full
14.8% of all soldiers suffered from epididymitis.

If this estimate is valid generally, that would imply that almost 22
million men in the US suffer from this condition.  What remedies help to
relieve the pain of epididymitis or clear up the condition altogether?

What is the Epididymitis?

On the back side of your testicles lies a coiled tube which carries your
sperm from your testicles, where they are created, to the ductus
deferens up to your penis, from where they can be launched to
impregnate a female. That coil is your epididymitis.  If you unwound
the coils, the epididymitis would be 20 feet long.  But the coils are so
tight that the entire length is only about  1.5 inches.

Because of the tight architecture of your coils, pain that originates in
your epididymitis can feel as though it is general pain in your testicles
or your scrotum. Also in part because of all that rope wound so tightly,
problems that occur anywhere along that cord can sometimes take a
while to resolve.

Symptoms of Epididymitis

-The pain can occur on one side (unilateral) or both sides (bilateral)
- the pain can be dull or sharp
- the pain can be mild, intermittent discomfort to constant and severe
- the pain can be triggered by or exacerbated by ejaculation

Causes of Epididymitis

-Chlamydia.  Epididymitis can be caused by chlamydia, a common
sexually-transmitted disease.  Look for an unusual discharge. One study
conducted in 2000 by researchers from the Center for STD Research
and Diagnostics in Bialystok, Poland determined that 58.3% of men
whose epididymitis was caused by chlamydia experienced a discharge
from their penis.  If you have contracted chlamydia, the symptoms may
include a white or cloudy discharge. The standard treatment for
chlamydia is an antibiotic (such as Azithromycin).

You can catch the chlamydia bacteria only from sexual activity
(intercourse, anal sex, sharing sex toys) but
not from toilet seats or

According to the Poland study and others, chlamydia-related
epididymitis occurs more often in younger men. The good news if your
epididymitis is from chlamydia, this form of epididymitis tends to be
short-lived, as compared with epididymitis from other causes. (Read
more about the
symptoms and remedies for the Top 10 STDs.)

Post-Bacterial Infection. Following an infection of bacterial
epididymitis, and after antibiotics have cleared up the infection, the pain
from the condition can persist. Again, because of the tight coiling,
extremely fine particles or obstructions – or scars – from a healed
condition can nonetheless cause pain until they move along and out of
the cord.

Urinary Tract Infections. Common urinary tract infections can cause
epididymitis. According to the Mayo Clinic, treatment for simple urinary
tract infections can include antibiotics such as

•Sulfamethoxazole-trimethoprim (Bactrim, Septra, others)
•Amoxicillin (Amoxil, Augmentin, others)
•Nitrofurantoin (Furadantin, Macrodantin, others)
•Ciprofloxacin (Cipro) or
•Levofloxacin (Levaquin)

The UK's National Health Service cautions that you may need to go to
the hospital for a urinary tract infection if you  
•are over 60 years old
•have severe vomiting
•have severe pain  
•are dehydrated
•can't pass urine, or you're passing smaller amounts of urine than usual
•have a blockage in your kidneys, such as a kidney stone
•have diabetes
•have been having chemotherapy or radiotherapy
•have a history of kidney disease
•have a history of recurring upper UTIs
•have HIV
•have sickle cell anaemia or
•have cancer

-Granulomatous epididymitis. Your epididymitis can become filled with
granules from sperm formations, several studies have found, including
a 2002 study from Department of Urology, Chikushi Hospital, Fukuoka
University, Chikushino, Japan and a 2004 study from the Postgraduate
Institute of Medical Education and Research, Chandigarh, India.  The
researchers suggest a needle aspiration to diagnose this problem.

Behcet’s Disease. This disease, which occurs mainly along the path of
the ancient Silk Road stretching between eastern Asia and the
Mediterranean, is a systemic inflammation in the body including the
central nervous system.  In this part of the world, about 10 out of
every 10,000 people have the disease, while in North America and the
UK, only 1 to 2 out of every 1 million people have it, according to a
2004 study from St. Marianna University School of Medicine in Japan.  
Behcet’s disease can cause chronic epididymitis, according to a 2000
study from Newton Wellesley Hospital in Boston. Along with the
inflammation of the epididymis, the men also had fever, mouth ulcers,
arthritis, uveitis,  and penile ulcers.  To treat the condition, doctors
administered colchicine, glucocorticoids, nonsteroidal anti-inflammatory
drugs and cyclosporine.

Idiopathic Epididymitis. Some cases of epididymitis stem from causes
which are never identified and are thus called “idiopathic”.

-Drug-Induced epididymitis. Amiodarone can cause epididy

Remedies for Epididymitis

1.        Do Nothing. Many doctors recommend “watchful waiting” for a
period of time. Unfortunately, this perid can be long, since epididymitis
symptoms last an average of 4.9 years, according to a 2003 study from
Queen’s University in Canada.

Scrotal Support.  Wearing tighter underwear or a jock strap
seems to help in some cases, the Queen’s University study reports.
Why? Because they keep your cord from hanging too low, being
stretched and causing tension along the cord.

Warm Compresses. If your epididymitis is general, and not STD-
related, then compresses help ease the pain. At night, place a warm
compress wrapped in a plastic bag against your testicles to keep your
cord from stretching and causing pain.

Sitz Baths. Sitting in a warm tub or, better yet, a gentle spray of
water such as from a shower head as you sit in shallow water, can
relieve epididymitis. The name "sitz" comes from the German word
"sitzen" which means to sit. With a sitz bath, also called a hip bath, you
sit in water shallow enough to cover only your buttocks and your hips.
Sitz baths work because they dilate the blood vessels and thus improve

Ice Packs. That’s right, the opposite of the warm compresses
can help, especially if your epididymitis is caused by proximity to
varicose veins.

Anti-Inflammatories. Epididymitis is an inflammatory disease,
so using common anti-inflammatories such as ibuprofen (Advil, Nuprin
and generic versions) can help in many cases.  Be careful to follow the
recommended dosage and length of time for using even these non-
prescription anti-inflammatories.

Treat Chlamydia. Get thee to a doctor! If you have chlamydia
the only remedy is a doctor-prescribed antibiotic. The usual treatment
is one dose of azithromycin or a twice-daily dose of doxycycline for a
week, although your doctor may choose another antibiotic.

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Sitting in a warm bath can relieve the pain of  
epididymitis. You only need  warm water. No
soap required!.