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Because epididymitis that affects both testicles can make a man sterile, antibiotic therapy must be initiated as soon as symptoms appear. To prevent reinfection, medication must be taken exactly as prescribed, even if the patient's symptoms disappear or he begins to feel better. Over-the-counter anti-inflammatories can relieve pain but should not be used without the approval of a family physician or urologist.
Bed rest is recommended until symptoms subside, and patients are advised to wear athletic supporters when they resume normal activities. If pain is severe, a local anesthetic like lidocaine (Xylocaine) may be injected directly into the spermatic cord.
Self-careA patient who has epididymitis should not drink beverages that contain caffeine. To prevent constipation, he should use stool softeners or eat plenty of fruit, nuts, whole grain cereals, and other foods with laxative properties.
An ice bag wrapped in a towel can reduce pain and swelling but should be removed from the inflamed area for a few minutes every hour to prevent burns.
Strenuous activity should be avoided until symptoms disappear. Sexual activity should not be resumed until a month after symptoms disappear.
If a second course of treatment doesn't eradicate stubborn symptoms, longterm anti-inflammatory therapy may be recommended. In rare instances, chronic symptoms require surgery.
SurgeryEach of the surgical procedures used to treat epididymitis is performed under local anesthesia on an out-patient basis. Both of them cause sterility.
Epididymectomy involves removing the inflamed section of the epididymitis through a small incision in the scrotum.
Bilateral vasectomy prevents fluid and sperm from passing through the epididymis. This procedure is usually performed on men who have chronic epididymitis or on elderly patients undergoing prostate surgery.
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