The causes of epididymitis tend to vary with age. In men over 35, epididymitis is usually caused by the same bacteria responsible for urinary tract infections. In many instances, the condition develops shortly after the man has a medical procedure involving the urinary tract, such as the insertion of a catheter (a flexible tube used to drain urine from the bladder) or a prostate biopsy (removal of a small tissue sample). Some patients actually have a typical bladder infection at the same time they are developing the signs and symptoms of epididymitis. In such cases, the bacteria spread up the urethra (the tube that urine and semen pass through) and enter the internal sex organs through the prostate.
In young men, however, epididymitis is usually the result of a sexually transmitted disease (STD), caused when a disease-causing microbe -- often chlamydia or gonorrhea -- enters through the urethra after a sexual encounter. It usually takes a week or more to develop epididymitis after acquiring the organism. Signs and symptoms are very similar to those seen in the non-sexually transmitted form of the illness, with one difference: There is often some discharge from the penis, as in typical urethritis (inflammation of the urethra).
The treatment of epididymitis is straightforward. A variety of antibiotics are quite successful in curing the infection. Since this condition can be quite painful, doctors usually recommend ice packs and pain-relieving medications to alleviate discomfort. If it seems likely that the infection was acquired sexually, the patient's partners should be evaluated and, as a rule, treated for possible asymptomatic (without symptoms) infection. Also, as with any sexually transmitted illness, screening for other STDs, such as HIV (the virus that causes AIDS), may be in order.
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