Here is a 2013 abstract from PubMed on acute epididymitis with some important findings:
"We evaluated adult patients with acute epididymitis to identify the frequency of actual sexual contacts and the causative organism, and compared clinical examinations, degrees of manifested symptoms, and radiological test results.
"We reviewed the medical records of 65 patients older than 18 years presenting with acute epididymitis who had been treated between 2002 and 2011. Scrotal ultrasonography, urinalysis, and urine culture were performed to diagnose the acute epididymitis. Patients were divided into negative (n=45) and positive (n=20) urine culture groups. Then the latter groups were subdivided into a sexually transmitted organism (STO) culture group (n=13) and a non-STO (n=7) culture group. Data on any history of sexual contact, scrotal pain and tenderness, symptoms of urethritis (discharge, dysuria, urethral burning, or irritation), and lower urinary tract symptoms (dysuria, frequency, and urgency of urination) were obtained from all of the subjects.
"Patients in the positive urine culture group were significantly younger than those in the other group (p=0.224) and were more likely to have a history of sexual contact at least two weeks prior to onset of epididymitis (p=0.012). They had also a significantly enlarged epididymal head and significantly more severe complaints of pain or tenderness than those of latter group (p=0.348, p=0.288). However, the difference in these measures between the STO and non-STO group was not significant, except in the case of age (p=0.044).
"Patients of the positive urine culture group with acute epididymitis were significantly younger and more sexually active than the others. They also had severe pain or tenderness and an enlarged epididymal head. There was a close association between clinical symptoms, a positive urine culture, and ultrasonographic findings."
Source:
Kim SD, Kim SW, Yoon BI, Ha US, Kim SW, Cho YH, Sohn DW. The Relationship between Clinical Symptoms and Urine Culture in Adult Patients with Acute Epididymitis. World J Mens Health. 2013 Apr;31(1):53-7. doi: 10.5534/wjmh.2013.31.1.53. Epub 2013 Apr 23.
Department of Urology, Jeju National University School of Medicine, Jeju, Korea.
PMID: 23658866
PMCID: PMC3640153
The disease caused by bacterial infection will require at least two weeks of antibiotic treatment. The medications given can include doxycycline, azithromycin, ofloxacin, ciprofloxacin, levofloxacin or trimethoprim-sulfamethoxazole. Cases caused by Mycobacterium tuberculosis will be treated by anti-tuberculosis medications. General treatment includes bed rest, elevation of scrotum and application of ice. The elevation will raise the scrotal sac above the level of heart improving blood flow and aids in rapid healing. Intake of plenty of water is recommended. Other than these non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen can also be of assistance. If amiodarone is the suspected causes then adjustment of the drug dose is recommended. The severe cases with exaggerated symptoms such as intractable pain, vomiting, very high fever or overall severe illness may require hospital admission. Surgical removal of testis may be required as treatment of Epididymitis in complicated cases. In case of chronic illness treatment is mainly directed towards reducing the discomfort.
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