Epididymitis is a disorder causing the inflammation of the epididymis (part of the male reproductive system where sperms are produced and nourished). This inflammation is usually caused by bacterial infection and can be cured by using antibiotics. But sometimes epididymitis does not go away even after the usage of antibiotics.
So, what to do when epididymitis not going away?
Mostly, antibiotics are used by males having acute epididymitis, as antibiotics kill or prevent the growth of bacteria. But severe inflammation of the epididymis can’t be completely cured by antibiotics, because bacteria causing chronic epididymitis are typically antibiotics resistant, or it may be non-bacterial epididymitis. So, other drugs like anti-inflammatory pills and diuretic pills are used.
If you want to know everything about it, keep reading.
Table of Content
Causes of Epididymitis
As discussed earlier, epididymitis is the inflammation of the coiled tube present within the sac-like body called the scrotum. In this tube, sperms are produced by the division of cells from the walls of the epididymis. These cells then undergo mitosis to form spermatocytes, which further undergo a division including meiosis to form spermatids.
These spermatids then differentiate into sperm having proper heads, necks, and tails. From all this discussion, it is now clear that epididymis is a part of the male reproductive system.
Sometimes the epididymis becomes infected by bacteria, as occurs in sexually transmitted diseases. Or it becomes inflamed due to other reasons including backflow of urine from the urethra, as the male reproductive system and male urinary system have the same opening to the outside, only through the urethra; traveling on a bike, cycle, scooter for a prolonged period; viral infection; increased period of sitting down.
STDs or Sexually Transmitted Diseases
The diseases spread through sexual contact are known as sexually transmitted diseases or STDs.
The epididymis can be caused by sexual activity if your partner has any sexually transmitted disease.
This type of epididymitis can be bacterial as well as viral. But inflammation due to bacteria is most common. There is also a further class of bacteria causing sexually transmitted diseases such as Neisseria gonorrhea, Escherichia coli, etc.
Neisseria gonorrhea is the most common bacterial infection, always caused by sexual activity. It can occur in all men who are involved in sexual activities. Infection, caused by the bacteria Chlamydia trachomatis, is also very common. This infection is also caused by sexual engagement, causing inflammation and pain to occur in the testis. Ureaplasma, small bacteria affecting both the urinary and reproductive systems, can cause epididymitis.
Many times, these diseases exist without any symptoms, but many symptoms can appear depending on the type and severity of the infection. The symptoms of STDs include:
- Discharge through penis
- Small lesions on the area surrounding the testis.
- Pain during urination and ejaculation
- Soreness on the testis and penis
- Rash on the lower abdomen
- Irritation and itching on the penis.
- Pain in the throat
- Swollen urethra
- Bleeding, but it is rare to happen.
As we have seen, most of the diseases are caused by bacterial infection. So, to stop the growth and to kill the bacteria, antibiotics are always used. Most antibiotics are taken orally, but can be injected. For viral infections, antiviral tablets are prescribed.
But in some cases, bacteria causing infection become resistant to the antibiotic drugs. That is why epididymitis does not go away. In these cases, antibiotics are of no use, and then anti-inflammatory drugs and diuretics are usually prescribed.
Non-sexually Transmitted Disease
There are any bacteria that can cause infection and inflammation, but it is not transmitted through sex, mostly.
Tuberculosis, caused by Mycobacterium tuberculosis, can also cause epididymitis by spreading these bacteria through blood. The bacteria, named Escherichia coli, can cause epididymitis in men due to urinary tract impairment.
Prostatic hyperplasia (a condition in which the prostate gland present around the urethra becomes swollen, narrowing the urethra, thus stopping or obstructing the flow of urine through it) can be a reason for Escherichia coli infection. This infection can also be caused by infected instruments including infected catheters, endoscopes, wires, etc., that are used for any kind of urinary tract treatment.
Infection caused by non-sexual methods can be of diverse nature, depending on the way causing infection. The most common symptoms are:
- Frequent urination
- Loss of control of urination
- Dribble after urination or anytime in between
- Fail to empty the urinary bladder completely
- Difficult start of urination
Epididymitis caused by prostatic hyperplasia can be treated with alpha-blockers and 5-alpha reductase inhibitors. These drugs help to remove the blockage of the urethra by affecting the smooth muscles of the urinary bladder and prostate gland. If the condition is not being controlled through drugs, then surgery can be done. Mostly, this condition can be treated through drugs, if no severe symptoms are there.
If the condition is caused by infected urinary tract instruments, then antibiotics and antiviral drugs are mostly prescribed. And in this case, if antibiotics fail to cure it, then anti-inflammatory and diuretics are prescribed.
Autoimmune Imbalance or Inflammation
Autoimmunity is a response produced by the immune system of the human body, killing the body’s own cells or tissues. It can cause many disorders.
Epididymitis can also be caused by the invasion of the body’s own antibodies due to autoimmunity of the body, causing inflammation.
Inflammation may occur due to some common viral diseases such as adenovirus, or also can occur after the treatment of this infection as post-effects causing epididymitis.
Inflammation of the epididymis can be caused by injury or trauma to the testis or by inflammation of blood vessels supplying blood to it.
The symptoms of epididymitis caused by the above-mentioned causes are almost the same as those caused by STDs and non-sexually transmitted infections.
It usually involves:
- Swollen epididymis
- Penis discharge
- Itching in the penis.
- Protrusions on the area around the penis
The epididymitis caused by inflammation and trauma or some injury can be treated by using NSAID non-steroidal anti-inflammatory drugs. In these cases, antibiotics usually do not work.
Epididymitis Not Going Away: Medications Causing Epididymitis
Epididymitis can occur as a side effect of some drugs. For example, a medication named amiodarone is an antiarrhythmic medication that combats cardiac dysrhythmias by preventing and treating them. This drug can induce epididymitis. If we take amiodarone in a high dose, it induces the antibodies to attack the lining of the epididymis, causing them to swell.
Epididymitis caused by the consumption of high doses of amiodarone has the same symptoms as discussed earlier.
It can be treated by NSAID or non-steroidal anti-inflammatory drugs. Antibiotics in this case usually do not work.
Riding on Bicycles
Epididymitis can also be caused by prolonged riding or sitting on bicycles for the longer term. As it puts pressure on the testis and can cause inflammation of the epididymis.
It can be cured by taking anti-inflammatory drugs and by avoiding the use of bicycles for lengthy periods.
Heavy Physical Activity
Lifting heavy objects can be a cause of epididymitis by causing a backflow of urine in the urethra and causing infection in the testis.
The use of antibiotics can cure this condition.
Epididymitis can be prevented by taking some precautions including controlled sex, use of condoms, using sterilized instruments to treat urinary tract infections, sitting on cycles for a shorter period, treating other infections of the urinary system as soon as possible, taking fewer doses of amiodarone, etc
Question: Why does epididymitis not go away even after using antibiotics?
Answer: In many cases, epididymitis is not caused by bacterial infection. It can be due to inflammation occurring for some other reason, including trauma or injury, or by the use of amiodarone. So, these conditions can’t be cured by using antibiotics. Further, many infection-causing bacteria become resistant to antibiotics, so can’t be cured by antibiotics.
Question: How riding a motorbike can cause epididymitis?
Answer: Sitting on the bike for longer, puts pressure on the testis, which can be painful. This can also cause inflammation of the epididymis.
Question: How long does it take to cure epididymitis?
Answer: It usually depends on the intensity of the epididymitis. If acute epididymitis occurs, it typically recovers within 5 to 7 days. But chronic condition often requires more time. It typically takes 15 to 30 days to recover. Further, it also depends on the dose of medicine you are ingesting. A high dose or more absorption of drug will help inflammation to recover soon.
The situation named epididymitis not going away after the use of antibiotics can occur when bacteria responsible for epididymitis develop resistance against antibiotics. Further, if inflammation is due to other reasons such as viral infection, trauma to the testis, side effects of other viral diseases, autoimmunity, and use of drugs like amiodarone, then antibiotics are of no use. In these cases, NSAIDs can be used.