Before prescribing a treatment, the doctor may request an ultrasound to confirm the diagnosis. This makes it possible to see the inflamed epididymis and to look for possible testicular involvement by checking its vascularity. In some cases, the diagnosis of epididymitis can be difficult. Indeed, the clinical symptoms may suggest a twisting of the spermatic cord which must systematically be evoked in front of any acute pathology of the bursae. This suspicion can lead to emergency surgical exploration, especially when the signs of infection are minor.
In any case, to fight against this epididymitis, the doctor will prescribe a cytobacteriological examination of the urine (a urine analysis). The results of this examination will make it possible to identify the germ responsible, as well as the antibiogram to define the profile of resistance of the germ to the antibiotics, and thus to choose the appropriate antibiotic.
For epididymitis, it takes two to three weeks of antibiotic treatment to reduce inflammation. During this time, if the pain is too strong, a suspensor can relieve momentarily. An attentive medical follow-up is necessary in order to remain vigilant on the evolution of the Infection and to prevent the risks of epididymal abscess and fistulization.
After the infectious episode, a urological exploration will be necessary to prevent any risk of recurrence by seeking in particular a prostatic or urethral obstacle, and to search, if necessary, a residual epididymal obstacle which can compromise the fertility.
My doctor wants to start the treatment without waiting for the results of the exams. Is this normal?
Yes, while waiting for the results (24 to 48 hours), your doctor prescribes a so-called "probabilistic" antibiotherapy. That is, it prescribes an antibiotic treatment that corresponds to the drug admitted to be effective in a situation where the nature of the microorganism responsible for the infection is not yet known. This is not a blind prescription! Once your doctor receives the results of your exams, he will correct the antibiotic prescription, if any.