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QUESTION: Hello Sr.,


I would like to know more about traumatic epididymitis. I got a ball hit in my right testicule it has taken 3 months ago. So, I went to the doctor and He told me that I had a chronic epididymitis and that I had a scar in the epididymis. Until now He gave Arcoxia an anti inflammatory and Amitriptyline to treat the pain. For me his answer is not right, since I got a hit and less than 30 minutes after that I got this pain and I really don't believe that I had an infection in 30 minutes.

I made an ultrasound with doppler, blood exam, urine exam and so on; All of that didn't result me in any answer regarding my pain. They did not find infection or any kind of different thing.
My pain is not so hard; however it is not comfortable to be in this pain all the time.

I have read so many articles and books that tell me the pain is regarding the spermatic fluid which pass on the spot (inside the epididymis) that hurts. In this website you can find one of the files (http://www.orlandohealthdocs.com/orlandourologygroup-dph/files/2011/09/DPHUrolog). I truly would like to know about this and of course know more how to treat this injury. Also, In the end of this article it says that being without sex it may help to cure this pain more quickly. Is it right? What Do I really have to do to be cured?

Thank you very much.
Sincerely, Fernando.

ANSWER: F:

The article is pretty good and I generally agree with it.  Traumatic epididymitis is due, in part, to direct inflammation from the injury and inflammation from any sperm that may have leaked out of damaged tubules inside the epididymis.  Treatment is antibiiotics as a primary therapy and prophylactic, plus symptomatic treatment with anti-inflammatories and rest.  Immediate treatment might be ice to minimize the early swelling and inflammation.

There are no studies that compare healing with sex and without sex, but we generally do not recommend sexual activity as it's likely to be painful.

Healing proceeds slowly and any swelling tends to take weeks to slowly heal.  As it heals, it produces scar tissue which can also cause some discomfort.

In some cases, a surgery to remove the damaged epididymis might be needed.  You should be following the advice of your urologist about your particular situation.

---------- FOLLOW-UP ----------

QUESTION: Hello Sr.,

I am so thankful for your answer. I found some more information on internet which says that Saw Palmetto is a good phytotherapy to cure this kind of pain. Also, I would like to know if it is normal to be in pain since I got a ball hit. Provided that I had sex and and sports activities the last two months (December and January), I just have stopped that this month (February).

Beyond it, I would like to know if it will be possible to be without pain since I have not practiced any sexual and sports activity. I mean, how many months usually does this process take to be ok?

I will come back to my doctor today and I expect your answer.

Thank you so much.
Sincerely, F.

Answer
F:

There is no actual scientific evidence that saw palmetto really helps.

It is normal to be in pain after a traumatic injury to a testicle.

Healing time is variable depending on the exact degree and nature of the injury.  There is no single answer to how long it may take for your pain to disappear.  

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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