Epididymitis Treatment

Epididymitis Antibiotic Treatment

Most patients with mild epididymitis does not require hospitalization and can be treated at home with antibiotics. Men with intense pain complicated epididymitis should be examined for testicular torsion or testicular abscess. A follow up exam should be considered to ensure that the infection has been cleared.

Epididymitis that is caused by gonorrhea and/or chlamydia infection and is treated with oral doxycycline for 10 days and ceftriaxone 250 mg in a single dose. An alternative antibiotic regimen to doxycycline is azithromycin for 10 to 21 days. Partners must also be treated to prevent reinfection.

For men with confirmed UTI infections caused by E. Coli but without chlamydia or gonorrhea, a regimen of Levofloxacin 500 mg once daily for 10 days is an effective treatment.

During antibiotic treatment for epididymitis, men can ease pain through bed rest or elevating the scrotum.  Aspirin can be taken to reduce testicular inflammation.

Does epididymitis treatment work?

Yes, prompt treatment of epididymitis often completely cures the problem.  Therefore, it is essential to seek diagnosis as soon as any symptoms arise. If treamtent of epididymitis is delayed, or if the antibiotics are not taken as described, then chronic problems can occur, such as epididymo-orchitis, decreased fertility, abscess formation.

Epididymitis Complications

If testicles are still swollen after antibiotic treatment, it may signal another problem such as:

• Testicular torsion
• Testicular tumors
• Testicular abscess
• Testicular infarction
• Tuberculosis
• Fungal epididymitis 

Testicular torsion and sudden onset epididymitis can be difficult to distinguish from physical exam alone. A testicular ultrasound can be used to make the proper diagnosis.  Testicular torsion, or a twisted testicle, will have reduced blood flow to the testicle.  Epididymitis, on the other hand, will have increased blood flow to the penis. 

Men with HIV are much more likely to have fungal epididymitis.