Acute epididymitis

For sexually transmitted acute epididymitis, prevention relies on protected intercourse using sheath condoms for penetrative sex.

One Cochrane review concluded that antibiotic prophylaxis prior to cystoscopy may reduce symptomatic urinary tract infections (UTIs) but not systemic infections.[25]Zeng S, Zhang Z, Bai Y, et al. Antimicrobial agents for preventing urinary tract infections in adults undergoing cystoscopy. Cochrane Database Syst Rev. 2019 Feb 21;(2):CD012305. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012305.pub2/full http://www.ncbi.nlm.nih.gov/pubmed/30789676?tool=bestpractice.com The authors also reported that these conclusions were based on low or very low quality data. Based on this review, antibiotic prophylaxis may be offered to older men who have known bladder outflow obstruction and are undergoing procedures involving instrumentation of the urinary tract. These reduce the risk of UTIs and hence may reduce the risk of epididymitis.

In cases of sexually transmitted acute epididymitis, it is prudent for the treating physician to discuss safe sex practices and barrier protection. Avoidance of sexual contact until completion of treatment of the patient and all sexual partners will help prevent reinfection. Patients with a proven sexually transmitted infectious epididymitis should be referred for screening for other sexually transmitted diseases.

In nonsexually transmitted acute epididymitis, general hygiene issues should be discussed alongside the evaluation of the patient's risk factors and investigation and treatment of any underlying urinary tract pathology.