Definition
The epididymitis headline the chapter concerning the scrotum disorders: it is an inflammation of the epididymis (a thin, long and twisted duct on itself that connects each testicle to its vas deferens).
Causes
In most diagnosed cases, epididymitis is caused by bacterial / mycotic / viral infections (in particular, E. Coli, gonorrhea, chlamydia and more rarely candidiasis and tuberculosis), bacterial prostatitis, urethritis. However, the causal element most implicated in the epididymitis is the absolute reflux of urine inside the epididymis (→ extreme physical effort, weight lifting).
Symptoms
Epididymitis is characterized by swelling and testicular pain (not surprisingly, the testicle can easily catch fire in case of epididymitis, causing orchitis) often associated with: difficulty urinating, dyspareunia, abdominal pain, pain during urination, painful ejaculation and / or bloody, fever, urethral leakage after squeezing the glans.
Tuberculosis epididymitis: more complex symptoms, characterized by swollen nodules, at the level of the lower area of the testicle
Information on Epididymitis - Drugs for Epididymitis Treatment is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Epididymitis - Epididymitis Drugs.
drugs
In the case of nonspecific epididymitis, the patient is generally treated with broad-spectrum antibiotic drugs, such as third-generation cephalosporins and quinolones. For the epididymitis associated with sexually transmitted diseases, a more targeted drug treatment is indicated. To lighten the painful symptoms, it is possible to take anti-inflammatory and painkiller drugs, to be associated with antipyretics if the epididymitis were also accompanied by alteration of body temperature. The elevation of the epididymis, absolute rest and, if necessary, the application of ice at scrotal level is recommended.
The following are the classes of drugs most used in the treatment against epididymitis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and posology for the patient, based on the severity of the disease, the health of the patient and his response to treatment:
Quinolones:
- Ofloxacin: in the case of non-specific epididymitis, it is recommended to take a dose of 200-400 mg every 12 hours, for 10 days. When it comes to epididymitis from sexually transmitted diseases, the recommended dose is 300 mg every 12 hours, for a period of 10 days: in the latter case, the sexual partner must also undergo an antibiotic treatment, to avoid the spread of infection. In particular, this drug is particularly indicated for non-gonococcal epididymitis in subjects over the age of 35 and for patients sensitive to Ceftriaxone or Doxycycline.
- Levofloxacin (eg Levofloxacin, Tavanic, Aranda, Fovex): administer 500 mg of the drug orally once a day for 10 days. Recommended for epididymitis due to venereal diseases: in this regard, the companion must also be treated with antibiotics.
- Norfloxacin (eg. Norflox, Flossac, Sebercim): for nonspecific epididymitis, it is recommended to administer the drug at a dose of 400 mg twice daily (every 12 hours) for two weeks.
- Enoxacina (eg. Bactidan, Enoxen): indicated for nonspecific epididymitis. Administer 200 mg of drug orally every 12 hours for 14 days.
Cephalosporins:
- Ceftriaxone (eg. Ceftriaxone, Pantoxon, Ragex, Deixim): indicated for the treatment of epididymitis associated with sexually transmitted diseases. The dosage is: 250 mg of drug to be taken intramuscularly (single dose) for gonococcal infections (gonorrhea). If the epididymitis was caused by chlamydial infections, doxycycline should be administered at a dose of 100 mg twice a day for 10 days.
Tetracycline:
- Doxycycline (eg Doxicicl, Periostat, Miraclin, Bassado): it is recommended to administer 100 mg of drug twice a day for 10 days, to be taken, if necessary, together with Ceftriaxone, as indicated by the doctor.
The third generation doxycycline + cephalosporin combination is recommended in case of first treatment from epididymitis due to sexually transmitted diseases
- Tetracycline (eg Tetrac C, Pensulvit, Ambramycin): it is recommended to take 500 mg of drug orally every 6 hours, for 10 days. Tetracycline is useful as an alternative to doxycycline.
Anti-inflammatories / painkillers: therapeutic isussides to lighten the epididymitis-dependent pain symptomatology prove useful for inflammation and to calm pain due to inflammation
- Ibuprofen (eg. Brufen, Kendo, Moment): take on the palate 200 to 400 mg of active ingredient (tablets, effervescent sachets) every 4-6 hours, as needed. In some cases, the analgesic can be administered intravenously (400 to 800 mg every 6 hours, as needed)
- Naproxen (eg. Aleve, Naprorex): it is recommended to take one 550 mg capsule twice a day (every 12 hours, unless further instructions from the doctor), as needed
- Acetaminophen (or Paracetamol: eg Acetamol, Buscopan compositum, Tachipirina) for acute pains of epididymitis associated with alteration of body temperature. Taken orally in the form of tablets, syrup, effervescent sachets, or suppositories, the drug is generally administered at a dose of 325 - 650 mg every 4-6 hours for 6-8 consecutive days, to bring down the fever.
Opioids : if the pain derived from the epididymitis was unbearable, opioids are recommended (exclusively for acute and stabbing pain)
- Hydrocodone (eg Vicodin, not sold in Italy) the dosage must be adjusted based on the severity of the pain and the patient's response. Generally, one tablet is prescribed every 4-6 hours: never exceed 5 tablets per day. It is also possible to combine antipyretic drugs in case of fever associated with pain and testicular inflammation.
In case of scrotal abscess or repeated epididymitis events despite pharmacological interventions, it is recommended to subject the patient to a surgical excision (partial or total) of the epididymis.
Indispensable total abstention from sexual intercourse until complete recovery from epididymitis.
