Epididymitis: Nursing

Epididymitis is an inflammation of the epididymis that most commonly affects young, sexually active clients assigned male at birth under 35 years of age. It is usually characterized by unilateral pain and swelling in the scrotum. First, let’s recall the anatomy and physiology of the epididymis, which is a tubular, comma-shaped structure curving superiorly and posteriorly around the testes. The epididymis collects and stores the sperm cells produced by the testicle until they are mature and capable of fertilization. During ejaculation, sperm leave the epididymis and travel via ductus, or vas deferens, to the prostate gland, where it enters the urethra to be expelled outside of the body. The urethra is also the way urine is excreted from the body, but during ejaculation, the bladder sphincter right above the prostate contracts and prevents urine from mixing with sperm.

Now, the causes of epididymitis often vary with age. The most common cause of epididymitis in clients younger than 35 is a sexually transmited infection or STI, especially from bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis. The most common cause of epididymitis in older clients and children, is an urinary tract infection or UTI with bacteria from the gastrointestinal tract, such as Escherichia coli. Less common causes of epididymitis include; viruses, such as mumps virus, as well as non-infectious causes, including trauma and irritation, medications like amiodarone, and autoimmune disease.In addition, there are also certain risk factors for developing epididymitis. Non-modifiable risk factors include being aged 20 to 39 years old and having congenital abnormalities of the genitourinary tract. Modifiable risk factors, on the other hand, include increased sexual activity, multiple sexual partners, and anal or unprotected intercourse. Other modifiable risk factors include urinary retention, which could be due to benign prostatic hyperplasia, or prostatitis; as well as engaging in sports with repetitive motions like jumping or running, and exercising or having sexual intercourse with a full bladder.