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Epididymitis refers to inflammation of the epididymis – a densely coiled tube, in which sperm mature and are transported from the testis to the vas deferens.
Epididymitis can be caused by a bacterial or non-bacterial (viral) infection, trauma or reflux of urine into the epididymis.
Males of all ages can get epididymitis. In many cases, epididymitis cannot be prevented. However, prompt treatment of a urinary tract infection may prevent infection from spreading to the epididymis. Taking appropriate precautions against sexually transmitted diseases will also reduce the risk of a child getting developing epididymitis.
Learn about the Department of Pediatric Urology at Children's Hospital Colorado.
Epididymitis usually presents with a gradual onset of scrotal pain that increases in severity over several hours. This is usually associated with swelling of the epididymis, which becomes tender to the touch. In time, fluid may accumulate around the testis – this is called a hydrocele – and the scrotum may become red and warm to the touch.
When epididymitis is caused by an infection, there are usually problems passing urine – this can include urinary frequency, urgency and pain with urination. It also may be associated with a fever, blood in the urine or urethral discharge.
A medical history and physical examination is performed in order to diagnose this epididymitis. A urine specimen will be obtained and sent for a urinalysis – this will help determine whether or not your child has a urinary tract infection. A scrotal ultrasound may also be performed to help distinguish epididymitis from other conditions that present similar symptoms.
Not all scrotal pain is due to epididymitis. In some cases, the pain may be the result of testicular torsion, twisting of the blood vessels in the testicle, which reduces blood flow to the testis. In most cases, emergency surgical intervention is required to untwist the spermatic cord in an effort to save the testis. Although this condition usually has a sudden onset and is associated with severe scrotal pain, this is not always the case. With this in mind, we recommend that all scrotal pain be assessed by a healthcare provider in a timely fashion.
A medical history and physical examination is performed in order to diagnose this condition, as the testicle is normal but the epididymis that lies behind the testicle is tender and painful. In addition, a testicular ultrasound and a urine sample are often performed to help decide on treatment and to ensure that there is not another problem affecting the testicle.
The primary treatment for epididymitis is rest. Elevation of the scrotum and intermittent application of an ice pack may be of some benefit. Ibuprofen is usually recommended for pain relief and to help reduce inflammation. When epididymitis is caused by a bacterial infection, an antibiotic is also prescribed.
With a world-class Pediatric Emergency Department with 24 hour pediatric imaging available, children with epididymitis will be evaluated in a timely, expert manner and receive appropriate care by recognized experts including pediatric urologists.
Certified Pediatric Nurse Practitioner