Epididymitis is inflammation of the epididymis, the coiled tube at the back of the testicle that stores and transports sperm. It commonly causes scrotal or testicular pain, swelling, and tenderness. This guide explains causes, symptoms, diagnosis, treatment, complications, and when to seek care.
Quick overview
- Inflammation or infection of the epididymis
- Common causes: bacterial infections (including STIs) and urinary pathogens
- Symptoms: unilateral testicular pain, swelling, urinary discomfort, sometimes fever
- Most cases improve with antibiotics and supportive care
Symptoms
- Gradual or sudden testicular pain
- Scrotal swelling and warmth
- Pain that can worsen with activity or standing
- Urinary urgency, frequency, or dysuria
- Fever or chills when infection is present
Causes
- Sexually transmitted infections (eg, Chlamydia trachomatis, Neisseria gonorrhoeae)
- Urinary tract infections or prostatitis that spread to the epididymis
- Noninfectious causes: trauma, chemical irritation, or reflux of urine into the epididymis
Diagnosis
- Focused physical exam of the scrotum and testicles
- Urinalysis and urine culture
- STI testing when indicated
- Scrotal ultrasound to exclude testicular torsion or to evaluate for abscess
Treatment
- Antibiotics tailored to likely pathogens and patient risk factors (eg, STI coverage for sexually active men)
- Supportive measures: scrotal elevation, cold packs in the acute phase, rest
- Analgesics and anti-inflammatory medications (eg, NSAIDs) for pain control
- Follow-up to ensure symptom resolution; adjust treatment if symptoms persist
Chronic epididymitis
- Symptoms lasting more than 6 weeks may be labeled chronic
- Management can include prolonged anti-inflammatory therapy, physical therapy, and in refractory cases urology referral for further evaluation
Complications
- Abscess formation
- Chronic pain or swelling
- Potential impact on sperm quality with severe or bilateral disease
- Rarely, infertility if untreated or recurrent
When to seek immediate care
- Sudden severe testicular pain (to rule out torsion)
- Rapidly increasing swelling or high fever
- Worsening symptoms despite treatment
Prevention and tips
- Practice safer sex to reduce STI risk
- Seek prompt care for urinary infections
- Avoid heavy straining or activities that exacerbate pain until recovery
Disclaimer
This content is for educational purposes only and does not replace professional medical advice. If you have concerning symptoms, consult a healthcare provider for evaluation and treatment.
