Burning During Urination and Scrotal Pain? Don't Rule Out Epididymitis!

If you're experiencing a burning sensation when urinating or a dull ache in the scrotum, it's not something to brush off. These symptoms may point to epididymitis — a condition that needs timely medical attention. Epididymitis mainly presents as scrotal discomfort, abnormal body temperature, urinary issues, and systemic discomfort. Typical symptoms include painful scrotal swelling, fever with chills, frequent and urgent urination, and radiating lower abdominal pain.

Scrotal pain often feels like a persistent dull ache or a sharp twinge on one side. It may worsen when standing or touching the area, and might come with swelling, redness, or warmth. Urethral Burning specifically presents as a urinary abnormality characterized by a burning sensation during urination. Urine tests often reveal an increase in white blood cells; some patients may have pyuria (pus in the urine) or hematuria (blood in the urine). Additionally, patients may experience fever with chills, frequent/urgent urination, and radiating lower abdominal pain.

Pathogenesis

1. Scrotal Pain

In many cases, chronic epididymitis that's left untreated can develop into an acute condition. The ongoing inflammation irritates surrounding tissues, leading to continuous or on-and-off scrotal pain. The scrotum houses reproductive organs such as the testes and epididymis, which may become inflamed due to chronic epididymitis, resulting in discomfort.

2. Burning Sensation in the Urethra

Due to pathogenic infections in chronic epididymitis, inflammatory factors can damage the mucous membranes of the urinary tract, causing a burning sensation in the urethra. This discomfort typically occurs during urination and may be accompanied by changes in urine color or abnormal odor.

Treatment Methods

1. Scrotal Soreness

(1) Antibiotic Therapy

Antibiotic treatment involves the use of specific antibiotics to inhibit or kill pathogenic bacteria, thereby alleviating the inflammatory response. It is particularly effective for cases of bacterial epididymitis accompanied by testicular swelling.

(2) Non-steroidal anti-inflammatory Drugs(NSAIDs)

Non-steroidal anti-inflammatory drugs can reduce the synthesis of prostaglandins in local tissues, thereby achieving pain relief. They are particularly effective in alleviating mild pain symptoms.

(3) Epididymectomy

The epididymectomy is a surgical procedure that involves the complete removal of the affected side of the epididymis. This method can completely remove the diseased tissue, achieving the goal of curing the condition. It is suitable for patients with chronic epididymitis that recurs frequently and is unresponsive to drug treatment.

(4) External Application of Chinese Medicine

External application of Chinese herbal medicine utilizes herbs with effects such as warming meridians, promoting circulation, and activating blood flow to resolve stasis. These herbs are applied directly to the affected area to improve local blood circulation and alleviate discomfort. This method is suitable for those who still experience mild swelling after the acute phase.

(5) Acupuncture Therapy

Acupuncture therapy regulates the flow of qi and blood by stimulating specific acupoints, aiming to relieve localized muscle tension and alleviate pain. It can also provide some therapeutic benefits for mild to moderate epididymitis-induced testicular soreness and swelling.

If diagnosed with epididymitis accompanied by scrotal discomfort, patients should avoid self-administering any medications that may affect reproductive health. Additionally, maintaining good personal hygiene—such as changing underwear promptly—can help reduce the risk of bacterial infection.

2. Urethral Burning

(1) Antibiotic Therapy

Options include quinolones, third-generation cephalosporins, macrolides, or sulfonamides. Treatment plans are determined by doctors.

(2) Adjunctive Drugs

α-blockers: Relieve urethral irritation.

NSAIDs: Reduce pain and burning.

Phytotherapeutic agents: Improve lower urinary tract symptoms.

(3) Physical Therapy

Warm sitz baths (40°C × 15 mins each session).

Perineal heat compress (promotes inflammation absorption).

(4) Lifestyle Adjustments

Avoid alcohol and spicy foods.

Avoid prolonged sitting/cycling (reduces pelvic congestion).

Regular ejaculation (prevents seminal vesicle stasis).

Additionally, if the patient experiences urinary symptoms such as frequent urination, urgency, or dysuria (painful urination), the possibility of a urinary tract infection (UTI) should be considered. In such cases, urinalysis or urine culture is typically required to determine the appropriate treatment plan. Patients are advised to avoid overexertion and maintain good personal hygiene to reduce the risk of inflammation. If symptoms persist or worsen, prompt medical attention is necessary to receive proper treatment.

In conclusion, if you're experiencing symptoms like urethral burning or scrotal soreness, it's crucial to consult a healthcare provider promptly. Early diagnosis of epididymitis can prevent complications. Staying on top of your hygiene, following your treatment plan, and getting regular check-ups can make a big difference in recovery and long-term reproductive health.