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Suggest Treatment For Chronic Epididymitis

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Posted on Fri, 23 Jan 2015
Question: Hi,

Ive been suffering from chronic Epididymitis for around 3 years now. It first presented itself as a small lump at the back of my right testicleand has persisted, presenting with it a dull aching pain that comes and goes. I have recently completed two courses of ciprofloxacin but the swelling has not.cleared up. I have had two ultrasounds, my doctor informed me that there may be preliminary signs if Epididymitis on my left also, but I feel no pain or swelling in that side. I am a smoker, but lead a relatively healthy lifestyle (good diet, though I work night shifts so am constantly fatigued and I have pre-existing back problems) and am Sti free. Am very worried that it has not "burned" out like so many other cases. Is it anything serious to worry about and will it lead to any complications such as cancer, infertility or loss of function? What can I expect if it persists? I cannot find anywhere local to have private treatment and have to wait 5 months for a urologist appointment.

Many thanks
doctor
Answered by Dr. Shoaib Khan (50 minutes later)
Brief Answer:
Spread of infection is more likely to result

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. There is actually nothing serious that should cause any concern sir, but I somehow do not believe in the medical system employed and followed in your country as an individual requiring medical attention has to wait for 5 months to receive it.

The only listed complications with persistent, recurrent or neglected (untreated) epididymitis are the following:

+Infection spreading to your testicles
+Infection spreading to your scrotum
+Reduced (although not complete loss) of fertility (very rare)

If it persists, either of these complications can result; there should not be any other loss of function sir. I hope you find my response helpful sir, please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (6 hours later)
Thanks so much for your prompt reply, your message has helped more than months of seeing my GP, unfortunately the healthcare system in UK leaves a lot to be desired and waiting months for specialist treatment is very common.

I am going to try arrange for my doctor to refer me to a private clinic, but I have a feeling that there isn't one for some distance. I'm growing a bit weary of their "wait and see" approach to all this but besides waiting for the appointment 5 months away my options seem fairly limited. I don't want to have to wait if there's a chance the infection could spread. There is an accident and emergency unit in my local hospital but I'm not sure if they'd take me. Do you have a course of action that you would recommend?

In regards to my social life, I have a girlfriend with whom I have an active sex life; there isn't any chance of her contracting any kind of infection from me is there? The pain seems to settle after sex which leaves me wondering if it may be a spermatocele, as I don't masturbate often (though I understand these aren't infectious and so wouldn't spread). The main symptom (when it flares up) is a hard lump on my epididymus that occasionally hurts.

Thank you again for your help, forgive the long post I just want you to know everything so you get the full picture. I would appreciate some advice on what course of action you would think is best, and also what kind of solutions can I expect? Thanks again.

doctor
Answered by Dr. Shoaib Khan (2 hours later)
Brief Answer:
Course of action provided sir

Detailed Answer:
Hello once again sir.

I am glad I could be of assistance. Yes indeed, your medical system works towards the comfort of the medical staff trying their best to avoid over-burdening them. You should visit countries like XXXXXXX where patients have to wait a maximum of a few hours, but get the medical attention they need.

A doctor in your country has working hours and time limit, so he can spend time with his family and do everything else he needs to. Our doctors are over-burdened, but do not complain because we have taken an oath and continue to respect it.

I do wish you can get into a private clinic, but also understand that it may pinch your pocket as well. My course of action would be the following:

+Physical examination
+Ultrasound examination of the affected region
+Introduction of a course of antibiotics during which regular follow-up visits would be conducted to monitor the response. If at all there is inadequate response, I would substitute the treatment regimen with a more suitable and effective one.

It is also noted that not all individuals respond well to a course(s) of antibiotics, and for them a repeat ultrasound may have to be conducted to look for abscesses or other abnormalities requiring surgery.

No sir, your partner cannot and will not contract anything from you from a simple epididymitis. But it is although important for you to know that sexual intercourse may result in aggravation of your discomfort, as you must have already noted. For this reason, doctors advise against sexual intercourse only in favour of the patient's comfort and not for any other reason. The symptoms you have described are just what can be expected from sexual intercourse with epididymitis.

Oh please do not apologise sir, I am here to help and no matter how long the post my time and advise is for all my patients, without a bias. I hope I have provided you with the course of action expected and also hope you can somehow achieve the same.

Please do not hesitate to write to me anytime and for anything, I am always here to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (7 hours later)
Thanks very much, you've been very helpful!

At the moment it isn't giving me too much grief, just persistent aching, but just want to be diligent and keep an eye on it in case the pain worsens. Your advice has helped so much in helping me decide what to do next.

In terms of another course of antibiotics, which would you recommend? I have no allergies, though as I said before I work through the night so spacing the doses evenly can sometimes be an issue (with cipro I was taking one around 10am when I slept and one around 6pm when I woke up).

I'm also taking other measures as of today to help things along; drinking more water to keep hydrated and taking vitamins. Is there anything else you would recommend in terms of lifestyle/diet that would promote a speedier recovery? (I read online somewhere that apparently watermelon is very good for symptoms apparently, and somewhere else that herbal remedies like fenugreek and fennel are effective too).

I understand that I may only have paid for two follow-up questions to my query so in the event I don't speak to you again, thank you for being so helpful.

All the best

doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
Wishing you lots of luck

Detailed Answer:
Hello sir.

I would recommend sulfamethoxazole and trimethoprim or levofloxacin, but please only suggest this to your doctor and do not take these on your own sir.

Well good hydration will certainly help to keep you more comfortable and avoiding masturbation and/or sexual intercourse is all thats really required sir.

Yes sir, the payment was for two follow-up queries; but if you wish to write to me again just top-up the current discussion or write a fresh one addressing it to me and I shall be at your service once again. I wish you lots of luck and a rapid uneventful recovery.

Best wishes sir.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Suggest Treatment For Chronic Epididymitis

Brief Answer: Spread of infection is more likely to result Detailed Answer: Hello sir and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. There is actually nothing serious that should cause any concern sir, but I somehow do not believe in the medical system employed and followed in your country as an individual requiring medical attention has to wait for 5 months to receive it. The only listed complications with persistent, recurrent or neglected (untreated) epididymitis are the following: +Infection spreading to your testicles +Infection spreading to your scrotum +Reduced (although not complete loss) of fertility (very rare) If it persists, either of these complications can result; there should not be any other loss of function sir. I hope you find my response helpful sir, please feel free to write back to me for any further clarifications, I would be more than happy to help. Best wishes.