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Epididymitis is usually caused by the spread of a bacterial infection from the urethra or the bladder. An acute onset (less than 6 weeks) is typically triggered by infectious etiologies. Bacteria are responsible for about 80% of cases. The most common infections that cause this condition are chlamydia and gonorrhea in young heterosexual men. In children and older men as well as homosexual men, bacteria that live in the intestines, such as Escherichia coli, are the main culprit. The treatment for epididymitis is with prescribed antibiotics. The treatment should start immediately after the diagnosis. Otherwise, serious complications may occur. Some complications are chronic epididymitis, abscess (pus accumulating inside the epididymitis), and permanent damage to the epididymis and testicles. It is definitely true that chronic epididymitis (having tenderness and pain that last longer than 6 weeks) can occur without an acute infection like when there is a residual inflammation, even though the infection has already been cleared. Sometimes the cause of chronic epididymitis is not identified. Its symptoms may come on gradually. The treatment for this condition with non-infectious causes of epididymitis is usually with anti-inflammatory medications; occasionally, a consultation with a urologist is recommended for additional treatments.
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