What causes left epididymitis?

Left-sided epididymitis is usually caused by bacterial infection, retrograde transmission of urinary tract infection, sexually transmitted diseases, structural abnormalities of the urinary system, or trauma. The main factors include bacterial retrograde infection, spread of urinary tract infection, chlamydia or gonococcal infection, congenital urinary system anomalies, local trauma or surgical stimulation and other factors.

1. Bacterial retrograde infection

Retrograde travel of intestinal bacteria such as Escherichia coli through the urethra to the epididymis is the most common cause. Patients may be accompanied by urethral irritation symptoms such as frequent urination and urgency. In the acute stage, scrotal redness, swelling, heat and pain may be seen. Treatment requires the use of antibiotics such as levofloxacin tablets and cefixime dispersible tablets as directed by the doctor, along with scrotal elevation to reduce swelling.

2. Spread of urinary tract infection

Urinary tract infections such as prostatitis or cystitis can spread through the vas deferens to the epididymis. Typical manifestations include fever with a feeling of swelling in the perineum, and elevated white blood cells can be seen in urine routine. Azithromycin capsules and tamsulosin hydrochloride sustained-release capsules can be used as directed by the doctor to control the infection, and the primary infection focus needs to be treated at the same time.

3. Sexually transmitted diseases

Chlamydia or gonococcal infection account for the main causes in young patients. A history of increased urethral secretions is common, sometimes accompanied by enlarged inguinal lymph nodes. Pathogen testing is required to confirm the diagnosis, and drugs such as doxycycline tablets and ceftriaxone sodium injection are often used for treatment. Sexual partners need to be treated simultaneously.

4. Urinary system abnormalities

Congenital malformation of the vas deferens or urethral stricture may cause urinary reflux and induce inflammation. Most of these patients have a history of recurrent attacks, and structural abnormalities can be found on ultrasound examination. In addition to anti-infective treatment, severe cases need to consider corrective surgery such as vas deferens recanalization.

5. Trauma or iatrogenic stimulation

Scrotal impingement, urinary catheter insertion, or prostate surgery may trigger a local inflammatory reaction in the epididymis. It usually presents with sudden severe pain accompanied by hematospermia, and emergencies such as testicular torsion need to be ruled out. In the acute stage, you can use ibuprofen sustained-release capsules as directed by your doctor to relieve pain, and use magnesium sulfate wet compresses to reduce swelling.

It is recommended to rest in bed and apply ice to the affected area during the acute stage, and to avoid strenuous exercise and sexual intercourse. Choose breathable underwear to reduce friction and keep the perineum clean and dry. Eat a light diet, drink plenty of water to promote metabolism, and limit spicy and irritating foods. If persistent high fever, scrotal suppuration, or worsening pain occurs, you need to seek medical attention immediately. Those with chronic and recurring symptoms should check for special infections such as urinary system tuberculosis.