What should I do if I have an epididymal nodule?

Written by Wang Shuai
Urology
Updated on September 13, 2024
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Many patients who have suffered from epididymitis will have a hard, smooth-surfaced, slightly tender, or asymptomatic nodule left on the epididymis after the swelling subsides and pain is controlled. This type of nodule is also referred to as a negative nodule. These nodules are difficult to completely eliminate with antibiotics, or may not be eliminated at all.

If the patient does not have significant discomfort, no special treatment is necessary. If the presence of the nodule leads to recurrent inflammation or significant pain, affecting the patient's normal work and life, it may be considered to apply local heat or gently massage to promote the reduction of the nodule. If these treatments do not effectively improve the condition, it is recommended to surgically remove the nodule from the epididymis.

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Written by Wang Shuai
Urology
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Does epididymitis require the removal of the testicle?

After developing epididymitis, in most cases, it is not necessary to remove the testicle. The appearance of epididymitis is mainly due to an infection by pathogens that causes the epididymis to become enlarged and painful. With early and timely anti-inflammatory treatment, generally, medication can lead to cure after one to two weeks for most patients, so surgical intervention is usually not necessary. If epididymitis is not treated promptly, it is very likely to cause inflammation of the testicle, and even lead to abscesses in the epididymis and testicle. In severe cases, it might become necessary to remove the testicle. Therefore, after developing epididymitis, one should promptly visit the urology department of a hospital for standard treatment to avoid unnecessary complications. (The use of medications should be under the guidance of a doctor.)

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Written by Wang Shuai
Urology
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Why is epididymitis getting more painful?

After suffering from epididymitis, the epididymis will show symptoms of enlargement and pain. If not treated promptly, the epididymis will further enlarge, and the pain will gradually become more pronounced, which is a normal phenomenon. However, if the pain continues to worsen despite active treatment, it should be considered that this may be due to a lack of attention to lifestyle care, such as engaging in vigorous exercise during treatment, or situations involving prolonged standing or sitting. Additionally, it is important to be vigilant about the possibility of testicular torsion accompanying epididymitis. Therefore, if the pain continues to worsen during the treatment of epididymitis, it is advisable to promptly re-examine the color Doppler ultrasound to understand the blood flow situation of the testicles and epididymis, and then proceed with targeted treatment.

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Written by Wang Shuai
Urology
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How is epididymitis caused?

Epididymitis refers to the inflammation of the epididymis, characterized by enlargement and pain, caused by infections from pathogens such as bacteria. The main cause of epididymitis is usually a preceding infection such as urethritis, bacterial prostatitis, or vesiculitis that was not timely treated. Bacteria spread along the vas deferens to the epididymis, leading to epididymitis. Additionally, trauma to the epididymis can also cause epididymitis. Another common scenario is related to certain medical procedures, such as prolonged catheterization or after undergoing plasma electrocautery surgery of the prostate, which can easily lead to epididymitis. Once epididymitis occurs, it is crucial to promptly treat it with antibiotics. During treatment, it is advisable to consume a light diet, avoid spicy and stimulating food, rest as much as possible in bed, and keep the scrotum elevated. (Specific medication usage should be conducted under the guidance of a doctor.)

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Urology
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How can an epididymal nodule be eliminated?

A significant portion of patients with epididymitis will have a hard nodule left at the site of the epididymis after inflammation control. This nodule is difficult to eliminate through medication. If the patient does not experience discomfort later on, local heat application or massage can be used to help dissipate the nodule. If the nodule does not cause any particular symptoms, no special treatment is needed. However, if the nodule is associated with significant pain or causes recurrent epididymitis, surgical removal of the epididymal nodule is recommended. After the surgery, timely anti-inflammatory treatment should be administered, and the wound should be kept clean and dry. Generally, recovery can be expected in about a week.

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Does epididymitis require surgery?

Patients with epididymitis generally do not require surgical treatment. In most cases, they are treated with oral medications or intravenous antibiotics, and typically recover within 1 to 2 weeks of treatment. However, if the symptoms of epididymitis are severe and not treated in time, leading to further aggravation of the condition or even formation of an epididymal abscess, surgical intervention may be necessary. Typically, this involves incision and drainage of the abscess to remove pus from the body. It is also important to regularly change dressings and keep the wound area clean and dry until it gradually heals. (Please administer medication under the guidance of a doctor.)