Chronic epididymitis is a common disease in the male reproductive system, attracting widespread attention in the medical field. We often hear about acute epididymitis progressing to chronic epididymitis, but does this statement reflect reality?

Firstly, we need to understand the characteristics of acute and chronic epididymitis. Acute epididymitis is an acute inflammation caused by bacterial infection, often presenting with severe pain, swelling, and redness of the testicle, requiring urgent treatment to prevent complications.

Chronic epididymitis, on the other hand, is a chronic inflammatory disease with a longer duration and milder symptoms. It is often accompanied by intermittent pain and discomfort, affecting the quality of life for patients to some extent.

Does Chronic Epididymitis Always Result from Acute Epididymitis?

Some patients may not receive timely or sufficient treatment, allowing some bacteria to remain in the epididymal tissue or causing latent infections that are not completely cleared. This may lead to the continuation or recurrence of acute epididymitis, ultimately progressing to chronic epididymitis.

However, not all cases of chronic epididymitis originate from acute epididymitis. There are other reasons:

1. Urethral Infection

When urethral infections are not promptly or adequately treated, bacteria can ascend from the urethra to the epididymis. Bacteria-containing urine can reflux into the ejaculatory duct, leading to epididymitis.

2. Prostate Issues

Some patients may have chronic prostatitis, which could result from the spread of inflammation from chronic prostatitis or reflux of bacteria-containing urine. However, some patients may not have had acute episodes before. 

Prostate enlargement surgery, due to the transurethral approach of prostatectomy and the ejaculatory duct's opening located within the prostate fossa, can cause urine to reflux into the ejaculatory duct, leading to chronic epididymitis.

3. Urethral Instrumentation and Long-term Indwelling Catheterization

These procedures can induce prostate infections and acute epididymitis, ultimately leading to chronic epididymitis.

4. Vasectomy

Patients undergoing vasectomy may experience poor drainage due to surgical factors, leading to the development of this condition.

5. Autoimmune Diseases

While relatively rare, some autoimmune diseases, such as Behçet's syndrome, can cause the immune system to mistakenly attack the body's tissues, including those of the male reproductive system. This autoimmune response may trigger inflammation of the epididymis, resulting in epididymitis.

Therefore, although acute epididymitis is a possible factor in chronic epididymitis, not all cases are caused by acute infections.

How to Treat Chronic Epididymitis?

1. Physical Therapy:

For patients with mild symptoms and short duration, observation may be recommended. Elevating the scrotum, local heat application, warm sitz baths, and physiotherapy can alleviate symptoms. It's also essential to avoid factors that may trigger or worsen symptoms, such as excessive sexual activity or prolonged sitting.

2. Medication:

Broad-spectrum antibiotics, such as cephalosporins or fluoroquinolones, are commonly used for chronic epididymitis to cover bacteria that may cause infection. Antibiotic treatment typically needs to be continued for a period to ensure complete eradication of the disease.

3. Natural Remedies:

Some patients may use herbal extracts or herbal medicine to alleviate symptoms. Diuretic and Anti-inflammatory Pill can clear heat, detoxify, reduce swelling and pain, improve local microcirculation, and enhance tissue metabolism, thus relieving epididymitis inflammation. Adhering to the medication can treat chronic epididymitis and effectively reduce the likelihood of recurrence.

4. Surgical Treatment:

For recurrent epididymitis, consideration may be given to vasectomy after ligation of the vas deferens before treatment. If local pain is severe, recurrent, and significantly affects daily life and work, epididymectomy may be considered.

5. Lifestyle Changes:

Maintaining good lifestyle habits, practicing personal hygiene, avoiding excessive fatigue, and managing stress are important. Moderate exercise can promote blood and lymphatic circulation, enhance the body's immune system, and prevent disease recurrence.

Recommended Readings:

Youth, How Can You Avoid Repeated Chronic Epididymitis

Why Traditional Chinese Medicine Treatment for Epididymitis Prevents Recurrent Episodes?

Is Epididymitis Considered Cured When It Doesn't Hurt Anymore?