Carl R. Darnall Army Medical Center - Health Library

Epididymitis

(Epididymo-orchitis)

Pronounced: Ep-i-did-uh-MY-tis

Definition

The epididymis is a tiny, looped tubule that sits on the back of the testicle. The tubule stores sperm and makes a path for sperm to pass out of the body. Epididymitis is an inflammation of the epididymis. It may be:

  • Acute—short lasting with treatment, often caused by infection
  • Chronic—lasts longer than 6 weeks or keeps coming back (less common); cause is not always clear

The Epididymis
si2188_testicle

Copyright © Nucleus Medical Media, Inc.

Causes  ^

Epididymitis is most often caused by an infection but can also be caused by an injury.

  • An infection may spread from a nearby structure. This may happen with a urinary tract infection or sexually transmitted disease (STD).
  • Injuries may be as a result of trauma or medical treatment such as chemotherapy or local surgery.

Sometimes the cause is not clear.

Risk Factors  ^

Only men can develop this condition but it can affect males of any age.

Infections that may lead to epididymitis include:

Other problems that may increase the risk of epididymitis include:

  • Use of a urethral catheter
  • Trauma
  • Recent surgery in the area such as prostate removal or vasectomy
  • Chemotherapy to treat bladder cancer
  • Birth defects of the genitourinary tract
  • Disease that affects the immune system
  • Treatment with amiodarone, a heart rhythm drug

Symptoms  ^

Symptoms will depend on the cause but can include:

  • Pain in the testicles
  • Sudden redness or swelling of the scrotum
  • Hardness, a lump, and/or soreness in the affected testicle
  • Tenderness in the unaffected testicle
  • Pain and/or burning during urination
  • Discharge from the penis
  • Pain during intercourse or ejaculation
  • Lower abdominal discomfort
  • Pain may spread to the groin
  • Fever or chills

Symptoms of chronic epididymitis may start more gradually.

Diagnosis  ^

You will be asked about your symptoms and medical history. A physical exam will be done. Epididymitis may be suspected based on the physical exam. Tests may be done to look for the underlying cause. These may include:

  • Urine tests
  • Urine culture
  • Urethral swab
  • Blood tests
  • Tissue tests
  • Testicular ultrasound

Treatment  ^

Treatment is important to prevent permanent damage. The specific treatment will depend on the cause. Options include:

Rest and support:

  • Bed rest may be needed until the swelling has decreased.
  • Use of athletic supporter for several weeks to elevate and support the scrotum.

Medication such as:

  • Antibiotics to treat a bacterial infection
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and swelling

If an STD is diagnosed, sexual partner(s) will need to be notified and treated.

Surgery may be needed for severe chronic epididymitis.

Prevention  ^

To help reduce your chances of epididymitis:

  • Practice safe sex. Protect yourself from STDs by using condoms.
  • Empty your bladder as soon as you feel the need. This may help decrease the risk of urinary tract infections.
RESOURCES:

National Kidney Foundation
https://www.kidney.org

Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Kidney Foundation of Canada
https://www.kidney.ca

REFERENCES:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/std/tg2015/default.htm. Updated January 25, 2017. Accessed October 9, 2017.

Acute epididymitis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114552/Acute-epididymitis. Accessed October 6, 2017. Accessed October 9, 2017.

Hori S, Sengupta A, Shukla CJ, Ingall E, McLoughlin J. Long-term outcome of epididymectomy for the management of chronic epididymal pain. J Urol. 2009;182(4):1407-1412.

Santillanes G, Gausche-Hill M, Lewis RJ. Are antibiotics necessary for pediatric epididymitis? Pediatr Emerg Care. 2011;27(3):174-178.

Last reviewed September 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 3/13/2017