Editing Epididymitis (section)

== Causes ==
Though urinary tract infections in men are rare, bacterial infection is the most common cause of acute epididymitis.<ref name=AMP09/> The [[bacteria]] in the [[urethra]] back-track through the [[urinary tract|urinary]] and [[human reproductive system|reproductive structures]] to the epididymis. In rare circumstances, the infection reaches the epididymis via the bloodstream.<ref>{{cite web |url=https://www.lecturio.com/concepts/epididymitis-and-orchitis/| title=Epididymitis and Orchitis
|website=The Lecturio Medical Concept Library |access-date= 19 July 2021}}</ref>

In sexually active men, ''[[Chlamydia trachomatis]]'' is responsible for two-thirds of acute cases, followed by ''[[Neisseria gonorrhoeae]]'' and ''[[E. coli]]'' (or other bacteria that cause [[urinary tract infection]]). Particularly among men over age 35 in whom the cause is ''E. coli'', epididymitis is commonly due to urinary tract obstruction.<ref name=brown>{{Cite book|title=Oxford American Handbook of Emergency Medicine|last=Brown|first=Jeremy|year=2008|page=992|publisher=Oxford University|place=New York|url=https://books.google.com/books?id=csdGgwKCIQUC&pg=PT841|isbn=978-0-19-518924-7}}</ref><ref name="Smith"/> Less common microbes include ''[[Ureaplasma]]'', [[Mycobacterium]], and ''[[cytomegalovirus]]'', or ''[[Cryptococcus (fungus)|Cryptococcus]]'' in patients with [[HIV infection]]. ''E. coli'' is more common in boys before [[puberty]], the [[elderly]], and [[homosexual men|men who have sex with men]].  In the majority of cases in which bacteria are the cause, only one side of the scrotum or the other is the locus of pain.<ref>{{Cite book|title=Sexually Transmitted Diseases: A Physician Tells You What You Need to Know|last=Marr|first=Lisa|edition=Second|year=2007|publisher=Johns Hopkins University |url=https://books.google.com/books?id=aywGiP9w-u8C&pg=PT36|isbn=9780801886591}}</ref>

Non-infectious causes are also possible. Reflux of sterile urine (urine without bacteria) through the [[ejaculatory duct]]s may cause inflammation with obstruction. In children, it may be a response following infection with [[enterovirus]], [[adenovirus]], or ''[[Mycoplasma pneumoniae]]''.  Rare non-infectious causes of chronic epididymitis include [[sarcoidosis]] (more prevalent in black men) and [[Behçet's disease]].<ref name=kav/>{{rp|p.311}}

Any form of epididymitis can be caused by genito-urinary [[surgery]], including [[prostatectomy]] and  [[urinary catheterization]]. [[Congestive epididymitis]] is a long-term complication of [[vasectomy]].<ref name="pmid10785217">{{cite journal |vauthors=Schwingl PJ, Guess HA |title=Safety and effectiveness of vasectomy |journal=Fertil. Steril. |volume=73 |issue=5 |pages=923–36 |year=2000 |pmid=10785217|doi=10.1016/S0015-0282(00)00482-9|citeseerx=10.1.1.494.1247 }}</ref><ref name="pmid8237740">{{cite journal |author=Raspa RF |title=Complications of vasectomy |journal=American Family Physician |volume=48 |issue=7 |pages=1264–8 |year=1993 |pmid=8237740 }}</ref> Chemical epididymitis may also result from drugs such as [[amiodarone]].<ref name="amiodarone">{{cite journal |vauthors=Ibsen HH, Frandsen F, Brandrup F, Møller M |title=Epididymitis caused by treatment with amiodarone |journal=Genitourin Med |volume=65 |issue=4 |pages=257–8 |date=August 1989 |pmid=2807285 |pmc=1194364 |doi= 10.1136/sti.65.4.257}}</ref>