Dear Alice,

I got epididymitis a month after surgery — two weeks after surgery got very bad flu — MD said flu virus settled in epididymis. Tried antibiotics, no success. Have now had epididymitis for 15 months. MD says can do nothing when epididymitis is viral based... just have to wait. Have looked at all possibilities... zero chance of STD related and urologist said not bladder or urethral caused. There has to be something to clear this up! Based on scale of one to ten, pain level has dropped from eight to constant three or four. Tired of hurting. Over last year have also developed major difficulty getting erections... can this somehow be connected to epididymitis? What can be done to get rid of epididymitis... permanently! Please advise.

Dear Reader,

It sounds as if you have been through quite an ordeal. Usually, epididymitis is an acute bacterial infection of the epididymis (the tube that carries the sperm in the testicles). Along with antibiotics, comfort measures, such as warm compresses and nonsteroidal anti-inflammatory medications (e.g., ibuprofen, acetaminophen, naproxen sodium, aspirin), usually clear up the infection and resolve the accompanying pain or discomfort within about two to four weeks.

Chronic epididymitis (lasting longer than six weeks) can occur without any bacterial infection present. It sometimes develops after a severe case of epididymitis or after multiple attacks of acute epididymitis. A chronic urinary tract infection sometimes also has been the source of chronic epididymitis.

If your health care provider decides that you have chronic epididymitis, you may be advised to take warm baths, use warm compresses, take nonsteroidal anti-inflammatory medications, or use medications that can relax some of the muscles in the area around your epididymis.

When chronic epididymitis results in severe chronic pain, some urologists inject steroids or numbing medicines directly into the structure within the testicle that contains the epididymis. This technique provides some relief for a few months, although it may not be a permanent solution. Some practitioners then repeat the injection, again providing the person with a brief window of relief.

As a last resort, surgery may be recommended to remove the entire epididymis (called an epididymectomy). This surgery has mixed results; research indicates that those who undergo epididymectomy due to chronic pain after a vasectomy or due to cysts on the epididymis have a better outcome than do those who undergo the procedure to solve nonspecific epididymal pain or chronic epididymitis. After epididymectomy, sperm from that testicle can no longer pass through to the outside; sperm from the other testicle still can, so an epididymectomy does not cause sterility.

When you have a medical problem that your current health care provider has not been able to adequately treat or explain, and when you notice new symptoms that aren't usually associated with the original problem (difficulty with erections), it is your right to get a second opinion from another health care provider. It makes sense, after fifteen months, to look for another urologist who has particular expertise in the treatment of epididymitis. If you don't have computer access, you can use the local public library's computer to find a specialist in your area, or you can get a referral from the urology department of the nearest major teaching hospital, your primary care physician, or your insurance company for a specialist that your insurance will cover.

By reaching out for more information, you have shown that you are an advocate for yourself. Now you can move on to verifying the diagnosis with another specialist, and to learning what other current or new, state-of-the-art or experimental treatments might be available for you.

Other readers can learn by your example.

Alice!

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