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What is the permanent cure for reoccurring epididymitis?

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General & Family Physician
Practicing since : 2006
Answered : 3551 Questions
Hi, I have a question regarding Epididymitus. I have had bouts of Epididymitus for the last three years. Normally they go or 95% go with a course of antibiotics. I got a flu two months ago and straight after that I had a re-occurrence of Epididymitus. I took a course of Cipro for 7 days and now am taking Keflax, of which I am half way through the 10 days recommended. So far there has been no real relief from the unilateral pain, symptoms include feeling sweaty, redness and a dull pain. All tests have been negative for STI, urine analysis and ultrasound. I don't want to keep on using antibiotics, any ideas.
Posted Tue, 21 Jan 2014 in Urinary and Bladder Problems
Answered by Dr. Albana Sejdini 1 hour later
Brief Answer: Risk factors for re-recurrent epididymitis.... Detailed Answer: Hi XXXX, The treatment of Epididymitis is long-termed and basically, antibiotics are the best choice. However, in your case, the re-occurring Epididymitis should be further evaluated for possible risk factors. In other words, we should focus more on those factors that can predispose epididymitis re-occurrence. Thus, I'd like to know: - have you been circumcised? - have you had frequent urinary infections in the past? - have you checked prostate recently? - you are saying that ultrasound did not show anything. Could you please indicate if the doctors have told you that your uro-genital tract is having some malformations? Could you please send in the results of ultrasound or other scan tests you had? Looking forward to have the additional medical data of yours to assist you further? Thank you! Dr.Alba
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Follow-up: What is the permanent cure for reoccurring epididymitis? 10 hours later
Thanks for your Answer. I have not been circumcised. No I have not had frequent urinary tract infections in the past. I have attended an urologist, about a year ago, had a prostate ultrasound, multiple blood tests and urine flow tests and an camera inspection of the area with no remarkable data for any of the tests. The last ultrasound of the testes that I had last week went to my GP. I do not have a soft copy to send to you. There were no remarkable results. There was a varicose vein there but it had little relevance. I have been scheduled for another one in a years time. All of my results and data are with my GP so i cant send them on to you. I had a urine test three weeks ago that indicated no infection in the urine. No blood and they could not culture anything from the sample. No test has really shown up anything of importance, main problem seems to be in the epididyimus, which upon inspection is tender near the head of the left epididyimus and the tail of the right epididyimus. I have been taking Ibuprofen 400 x 3 daily and the antibiotic and have not seen much improvement. Usually after taking antibiotics the problem dies down considerably. Having said that it has also never disappeared completely over the three years that I have had it. Regards and thank you.
Answered by Dr. Albana Sejdini 9 hours later
Brief Answer: Circumcision a permanent solution to epididymitis. Detailed Answer: Hi back, Thank you for following up. You are saying not to be circumcised. To my experience, such genital infections (if not STDs), are related to being uncircumcised. At the next appointment with your urologist, I'd suggest to discuss with him/her about circumcising. There is no harm of being circumcised; even when it comes to your sexual life (no changes). Next, you are saying that antibiotics are not doing enough effect on you. In these cases, usually, a culture of urethral liquid/seminal fluid is done to determine the right antibiotic for your infection. Although urine tests are cleared and no infection, your real infection is in your genital tract; that's why urethral/seminal fluid sample is taken to do the culture and sensitivity. Meanwhile, while you have been so long on antibiotic treatment, I'd suggest to discuss with your doctor regarding fungal infection triggered by antibiotics use. So, you must be properly treated with anti-mycotics. Hope it answered to your query! Dr.Alba If you are satisfied of the answer, please close this thread and kindly rate it. Thank you!
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Follow-up: What is the permanent cure for reoccurring epididymitis? 38 minutes later
Thanks Doctor thats a great answer. I'll leave the circumcision for a little as I was uncircumcised for 28 years with no problems. I will bring it up with my urologist when I get over this problem. I have had extensive testing with no results, but not a test on seminal fluid so that will be a good thing to bring to my doctor. So a couple of questions before I say goodbye. 1 Am i right in thinking that although there was no trace of blood or infection from my urine sample, there may be an infection in the genital tract that has not shown up in the testing that is not been treated by the cipro or the keflax? 2 As the antibiotics have not really worked should I talk to my doctor about stopping the course? 3 Is there any point in trying something like Azithromycin after the Keflax, or is it going a bit far after all the other antibiotics? Thanks Actually make that 38 years.
Answered by Dr. Albana Sejdini 24 minutes later
Brief Answer: Insist in repeating culture&sensitivity testing. Detailed Answer: Hi XXXX, 1. Yes, you are right. Urinary tract is different from genital tract although there is only one whole for urine or semen to pass through. So, urine is clear, but urethral/seminal fluid could have problems. There is a specific technique performed by the urologist to get the seminal fluid or to get the sperm cultured. Cipro and keflex, to my judgment, failed to treat your infection. There is a need of culture and sensitivity to determine the right antibiotic or anti-mycotic. The culture must be carried out for bacteria and fungal infection at the same time. 2. If you started the course 1 week ago, and no improvement, I'd suggest to stop taking it further; wait for 1 more week without medication and repeat the tests after 1 week from stopping the medicines to avoid false results. Please bare in mind that if you will have the culture before 1 week, the results will be negative (with no infection) as there is still antibiotic inside your system fighting the infection. That is why I am recommending to take a break before doing culture testing. 3. Azithromycin is the best choice for genital infection. Usually, to my experience (as I am lab doctor myself), keflex (cephalexin) is not having much effect on such infections. To my experience, there is always a positive feedback to Azytrhomycin intake. However, I insist to do culturing before "experimenting" with Azythromycin again. Hope it helped! Dr.Alba If satisfied with my answer, kindly give a positive feedback when rating it. Thank you!
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