Typical symptoms of epididymitis
The typical symptoms of epididymitis consist of Severe pain in the lower abdomen or in the pubic bone Swelling of the testicles and epididymis Sensitivity to pressure and touch Reddening, warming, swelling of the scrotum Pain when urinating Increased urge to urinate and feeling of residual urine Fever with possible chills General feeling of illness and reduced performance
- Severe pain in the lower abdomen or in the area of the pubic bone
- Swelling of testicles and epididymis
- Pressure and touch sensitivity
- Redness, warming, swelling of the scrotum
- Pain when urinating
- Increased urge to urinate and feeling of residual urine
- Fever with possible chills
- General feeling of illness and reduced performance
Testicular pain, which develops in the context of an epididymitis, usually occurs acutely, rarely also chronically. They are characterized by a dull, cramp-like pain that can radiate into the area of the pubic bone and the lower abdomen. Compared to other types of pain, testicular pain is often perceived as particularly severe.
Pain in the testicles can be perceived as so severe that walking and sitting may be restricted. It should be noted that in any case of acute testicular pain an emergency urological examination should be performed to rule out torsion of the testis as the cause. In this clinical picture, which occurs mainly in children, the rotation of the testis causes a pinching of the supplying and draining vessels, which can lead to the death of the testis if it persists for a long time.
Inflammations of the epididymis are often caused by infections of the bladder, prostate or urethra. All these infections can cause severe pain when urinating. These start acutely during urination and only subside slowly a few minutes after complete micturition.
Pain during urination is often associated with a frequent need to urinate, which in combination can be extremely annoying and painful for those affected. You suffer from pain when urinating?- more information on this can be found here: Pain while urinating in menOne of the most prominent symptoms of acute epididymitis is the swelling of the epididymis, the testicles and the scrotum. The disease usually begins with a slight, easily palpable swelling of the epididymis, which then spreads to the testicles.
The swelling of both structures can lead to a significant increase in size. In the course of the disease, the inflammation leads to a significant swelling of the scrotum of more than 10 cm due to increased inflammatory water retention in the scrotum. Restrictions in walking and sitting may occur.
After the diagnosis of an epididymitis, a rapid reduction of the swelling can usually be achieved by elevating the testicles and cooling them. If an epididymitis is due to an infection or obstruction of the urinary tract, there is usually an increased urge to urinate (pollakiuria) in addition to pain when urinating. Since the amount of urine is usually very small, there is no overall increase in urination.
Possible infections include inflammation of the bladder or urethra. However, a narrowing of the urinary tract, for example due to an inflammation of the prostate gland with accompanying swelling of the prostate, can also lead to frequent urination. Epididymitis can lead to the classic symptoms of local inflammation.
In addition to pain, swelling, loss of function and overheating, these include reddening of the affected structure and the overlying skin. Usually the reddening of the scrotum occurs somewhat later, when the epididymis and testicles already show a clear swelling. A hardening of the scrotum is caused by an inflammatory accumulation of fluid on one side of the scrotum.
The fluid continues to accumulate during the course of the inflammation and, above a certain size, leads to a tension of the scrotum skin, since it cannot expand any further. The typical folding of the skin is eliminated in this case. In this case the skin hardens, warms up and is accompanied by a considerable swelling of the scrotum.
In addition, an increased vascular drawing of the skin is often visible. In the case of a pronounced finding of an epididymitis, systemic involvement may occur, accompanied by fever up to 40°C, general exhaustion and a reduction in performance.Especially with the initial rise in temperature, the fever is usually accompanied by chills. The frequently used painkillers in the context of the therapy of an epididymitis, such as ibuprofen or paracetamol, not only relieve the pain and inhibit inflammation, but usually also reduce the fever.
After initiation of antibiotic therapy, the fever should subside significantly after 2-3 days if the effect is sufficient. Nausea and vomiting can also occur as accompanying symptoms in the context of testicular and epididymitis. In some cases this is due to a systemic reaction to the inflammation and to the existing testicular pain, which can often lead to nausea and vomiting.
Antiemetics, drugs against nausea, usually do not have to be used, since after initiation of antibiotic and pain therapy, the symptoms of nausea usually disappear quickly. There are numerous different causes that can lead to the development of acute lower abdominal pain. One of these possible causes is inflammation of the epididymis and the testicles.
The pain is usually described as dull and crampy. In addition to the focus of pain in the scrotum, pain is usually reported to radiate to the lower abdomen or pubic bone. However, the pain can also be due to a cause triggering the epididymitis, such as a urinary bladder infection or prostatitis.
In principle, children have a higher risk of developing epididymitis and testicular inflammation than adults. However, since newborns and infants cannot articulate their symptoms, a close observation of the children’s behavior must be made in order to be able to draw conclusions about any existing symptoms. For example, pain when urinating is expressed by crying and screaming, as well as the unwillingness to go to the toilet.
In addition, the child’s reaction to the pain focus can often be deduced from the abdominal palpation. General local signs of inflammation, such as fever and the swelling, warming and reddening of the scrotum, are however also groundbreaking findings in the diagnosis of epididymitis in children. In male children with acute lower abdominal pain and swelling of the scrotum, torsion of the testis, i.e. twisting of the testis with subsequent vascular occlusion, must always be ruled out by ultrasound.
