EPIDIDYMITIS

DEFENITION
Epididymitis is an inflammatory process that
occurs in the epididymis.
The epididymis is a structure that forms a
curve (coil) that attaches behind the testes
and is made as a storage place for mature
sperm.
 CLASSIFICATION
Based on the onset of pain, Epididymitis can be
divided into:
• Acute epididymitis: has pain and swelling in
just a few days while on
• Chronic epididymitis: the onset of pain and
inflammation in the epididymitis has lasted for
at least six weeks accompanied by the
emergence of induration in the scrotum.
 EPIDEMIOLOGY
Epididymitis can affect men of various ages,
but most often at the age of 19-35 years
 ETIOLOGY
The cause of epididymitis depends on your age and behavior, such as:
• Sexually transmitted diseases: the main causes of epididymitis in young
men (<35 years) are Neisserria Gonorrhea and Chlamidia trachomatis.
• Infection: non-sexual bacterial
• Amiodarone (Pacerona)
• Urine in the epididymis (chemical epididymis) occurs when there is urine
flow in the opposite direction due to lifting heavy objects or straining.
• Trauma due to a thigh injury.
• Tuberculosis infection: this condition is a rare cause.
• Torsion testis.
• Behḉet's disease.
• The most common children and parents are IE.coli or Ureoplasma
ureolitikum
 RISK FACTOR
• Having sex with a sexually transmitted disease sufferer, without using
condoms.
• Has a history of sexually transmitted infections.
• Have performed medical procedures that affect the urinary tract.
• Has prostate enlargement.
• Have been infected with a prostate infection or urinary tract
infection.
• Uncircumcised men.
• Has an abnormal anatomic location of the urinary tract.
• Use a urine catheter for the long term.
• Has Tuberculosis
• Using Amiodarone medicine
 PATHOGENESIS
This inflammation is thought to originate from
bacteria that are in the bladder, prostate, or
urethra which ascending into the epididymis.
Can also occur urine reflux through the
ejaculatory duct or hematogenous spread of
bacteria or directly to epiididitis as in the
spread of tuberculosis bacteria.
 CLINICAL MANIFESTATION
• Epididymis is painful and swollen
• Fever
• Goosebumps
• Urinating frequently and always feeling incomplete and painful
• Discharge from the penis
• Testicular pain
• Sex hurts
• There is blood in semen.
• The scrotum will swell, feel warm, and pain when touched.
• Lumps appear around the testes caused by fluid buildup.
• Discomfort or pain in the lower abdomen or around the pelvis.
• Enlarged lymph nodes in the groin.
 DIAGNOSIS
To find out the cause of epididymitis, the doctor
will recommend several types of tests, such
as:
• Fluid sample test.
• Blood and urine tests.
• Digital rectal examination.
• Ultrasound.
 TREATMENT

• Treatment of epididymitis aims to treat infections and

relieve symptoms that arise. One way is by administering
drugs, such as:
• Antibiotics. Examples of antibiotic drugs are doxycycline
and ciprofloxacin.
• Pain relievers. Examples are paracetamol or ibuprofen.
• In patients under 35 years old with germs that cause
Chlamidia or N. gonorrhea, the selected antibiotic is
amoxicillin, accompanied by probenecid or ceftriaxone that
is given intravenously. Then proceed with administration of
doxycillin or erythromycin orally for 10 days.
patients can make an independent effort at
home to help relieve the symptoms of
epididymitis. Among them by:
• Lying in bed for at least 2 days, with scrotal
position raised (assisted support).
• Compress scrotum with cold water.
• Avoid lifting heavy loads.
• Avoid sexual relations with other people to
prevent the spread of infection
surgical procedure:
In cases of epididymitis that are not successfully
treated with drugs, the doctor will
recommend surgery. This procedure can be
done if pus has arisen in the epididymis.
In other more severe cases, the patient must
undergo epididymectomy or surgical removal
of the epididymal canal.
 COMPLICATIONS
• abscess (suppurating infection) in the scrotum.
• infertility.
• Tearing of the scrotal skin layer.
• Death of testicular tissue due to lack of blood
(testicular infarction).