What is the cause and treatment for epididymitis?

Question

Hello doctor,

I am a 30-year-old male. I had pain below the belly, which, on the next day, passed to the left scrotum and was swollen. I visited a urologist and got USG done on the scrotum, blood test, urine test, urine culture, and sugar. Left epididymitis with reactive hydrocele was noted. Nothing was found in my blood and urine test reports. Uroflow was done, and it was 356 ml/19.6 ml per second max/8.5 ml per second average. I was given four weeks of Doxybond medicine twice a day and Alfoo for four weeks. Scrotum support is also used, and there is no pain after the second day after I started taking medicines. After four weeks of USG KUB, the PVR scrotum was done again with uroflow. Nothing in USG KUB PVR (450cc pre/9cc post void), but the USG scrotum showed no infection. But, chronic left epididymitis was said in the report because I still had a swollen left cord. No pain or hydrocele was noted. Uroflow 750 ml/ 22 ml per second 8 ml per second. The doctor said this chronic epididymitis will persist for some time or may not go ever, but no side effects will be there in the future. Now, Doxycycline has been stopped, but Alfoo has continued for two months because the uroflow is not good, as per the doctor. Now, I am taking Alfoo for four days and have stopped Doxybond, and I will get uroflow done in two months again. Is the treatment right or not? What is the ideal uroflow for the age of 30 years? What could be the cause of epididymitis? Could it be due to masturbation or sex? I only have one sex partner (wife). Should I get a CT or MRI done to find the cause of epididymitis and prevent it in the future? Could epididymitis come again? Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and seen all reports (attachment removed to protect patient identity). Treatment done is right, and nothing to worry about. After an acute epididymitis episode, there is a high chance that it can turn into chronic epididymitis, as in your case. It may take time to resolve, but nothing to worry about now. You may feel small swelling or discomfort on and off. Your uroflow is near to perfect; nothing to worry about. Not only numbers but also the flow pattern must be seen. So, we cannot defy normal based on numbers. Your numbers are fine, but the pattern is slightly disturbed. But nothing to worry about. Continue Alfoo as advised. There can be many causes of epididymitis, but in most cases, it is idiopathic (cause not known). In your case, it could be idiopathic or sexual. Masturbation does not cause epididymitis. It can be sexual. There are no tests to differentiate if it is idiopathic or sexual. No requirement for CT (computed tomography) or MRI (magnetic resonance imaging) at all. Yes, it can come in the future, but chances are very low if it is idiopathic. As in your case, it is likely to be idiopathic, as all other USG (ultrasound) and reports are normal.

I hope this helps.

Please revert in case of further queries.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

You may feel heaviness in the scrotum for some time. If there is no urine filling or urine leak, only heaviness, it is just because of infection. It is just you are correlating with the passing of urine.

I hope this helps.

Please revert in case of further queries.

Thank you.