b. Signs and Symptoms. Included are the following:
Fever and pain in the scrotum.
(2) Rapid unilateral swelling of the scrotum. (The scrotal sac is usually
slightly swollen and a dusky red). The testes are normal.
(3) A marked tenderness over the spermatic cord, a tenderness which is
relieved by lifting the testes (abnormal epididymis).
Pyuria (pus in the urine).
Bacteriuria (bacteria in urine).
The problem may involve the testis and/or the entire spermatic cord.
c. Treatment. There are three main goals in treating epididymitis: reduce the
pain, reduce the swelling, and combat infection. Begin treatment immediately since
sterility is always a threat. Treat as follows:
In males less than 30 years of age, torsion of the testicle should first be
(2) In more severe cases, antibiotics such as tetracycline may be used. In
men over 35 years of age, E. coli is the most frequent causative organism. For these
patients, trimethoprim-sulfamethoxazole, ampicillin, or a cephalosporin should be used.
Scrotal support, for a week to 10 days.
Scrotal ice packs.
Sitz baths, 2 to 3 times a day.
Rest and sedation.
Avoidance of straining and sexual excitement.
Within the spermatic cord, there is a network of veins referred to as the
pampiniform plexus. A varicocele is an abnormal dilation of these veins. In physical
examination, these veins feel like "a bag of worms."