It is commonly seen in young and middle-aged adults, often caused by infection from prostatitis or seminal vesiculitis, with hematogenous infection being rare. This condition is one of the common diseases of the male reproductive system. Epididymitis is mostly caused by the spread of infection from adjacent organs. Symptoms include sudden pain in the scrotal area, swelling of the epididymis, obvious tenderness, and may be accompanied by fever or epididymal nodules. Acute epididymitis is often secondary to infections of the urethra, prostate, or seminal vesicles, while chronic epididymitis usually results from incomplete treatment during the acute phase.

bubble_chart Clinical Manifestations

This condition falls under the scope of Chinese medicine epididymitis and orchitis. The clinical manifestations include sudden onset, pain and swelling in the scrotum, accompanied by systemic infection symptoms such as fever and aversion to cold. The pain may radiate to the groin, lower abdomen, and perineal area.

bubble_chart Diagnosis

Acute Epididymitis

1. Symptoms: General malaise, chills, fever, swelling and pain in the scrotum with a dragging sensation, radiating to the groin and lower abdomen.

2. Examination: Redness and swelling of the scrotum, enlarged epididymis that may involve the testis, marked tenderness. In severe swelling or when both the epididymis and testis are enlarged, differentiation between the two may be difficult. The ipsilateral spermatic cord becomes thickened and firm, with tenderness. Elevating the scrotum may alleviate the dragging pain. Blood tests show an increased white blood cell count.

Chronic Epididymitis

1. Dragging sensation, discomfort, or dull pain in the scrotum.

bubble_chart Treatment Measures

Acute Epididymitis

During the acute phase, bed rest is advised, with the scrotum elevated. Antibiotics, analgesics, and physical therapy should be administered. If an abscess forms, incision and drainage are required.

Chronic Epididymitis

Symptomatic treatment includes scrotal support, local physical therapy, and spermatic cord block. For recurrent or refractory cases, epididymectomy may be considered.

1. Maintain a regular lifestyle, balance work and rest, and avoid spicy or irritating foods.
2. Refrain from alcohol and smoking.
3. Avoid prolonged sitting.
4. Avoid excessive sexual activity.
5. Ensure regular bowel movements.
6. Take warm sitz baths or apply local heat for about 20 minutes each session.
7. Use antibiotics appropriately.