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- Urinary tract infection
- Sexually transmitted diseases (STDs), such as chlamydia and gonorrhea
- Infection of the urethra ( urethritis )
- Infection of the prostate ( prostatitis )
- Age: 15-30 (sexually transmitted bacteria is a common cause)
- Age: over 60 (urinary tract infections are a more frequent cause)
- Infection of the genitourinary tract (urethra, bladder, kidney, prostate, or testicle)
- Narrowing of the urethra
- Use of a urethral catheter
- Infrequent emptying of the bladder
- Recent surgery or instrumentation of the genitourinary tract (especially prostate removal )
- Birth defects of the genitourinary tract
- Unprotected sex
- Disease that affects the immune system
- Pain in the testicles
- Sudden redness or swelling of the scrotum
- Hardness, a lump, and/or soreness in the affected testicle
- Tenderness in the nonaffected testicle
- Groin pain
- Inflammation of the urethra
- Pain during intercourse or ejaculation
- Pain and/or burning during urination
- Increased pain while having a bowel movement
- Lower abdominal discomfort
- Discharge from the penis
- Urinalysis—to check for high white blood cell (WBC) count and the presence of bacteria
- Urine culture —to identify the type of bacteria present
- Culture or other test of discharge from penis
- Blood test—to measure the WBC count
- Ultrasound—a test that uses sound waves to examine the scrotum
- Bed rest—This keeps the testicles from moving and promotes healing. You may need bed rest until the swelling goes away.
- Antibiotics—You will be given antibiotics to treat a bacterial infection. Many cases of epididymitis are caused by sexually transmitted bacteria. Chlamydia is one of the most common. If you have an STD , your partner(s) will also need treatment. Take all of your antibiotics, even if you begin to feel better.
- Oral anti-inflammatory medication—This includes drugs like ibuprofen , to help reduce swelling.
- Scrotal elevation and support—You may need to wear an athletic supporter for several weeks.
- Hot baths—Taking baths can ease the pain and help relieve swelling.
- Surgery—May be needed in severe cases that keep coming back.
- Practice safe sex. Protect yourself from STDs by using condoms .
- Empty your bladder as soon as you feel the need.
National Kidney Foundation http://www.kidney.org
Urology Care Foundation http://www.urologyhealth.org
Canadian Health Network http://www.canadian-health-network.ca
The Kidney Foundation of Canada http://www.kidney.ca
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR . 2010;59(No. RR-12):1-110.
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2006: epididymitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/treatment/2006/epididymitis.htm . Updated April 12, 2007. Accessed July 15, 2010.
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guide: 2006. MMWR . 2006;55. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/treatment/2006/rr5511.pdf . Accessed February 5, 2008.
Hori S, Sengupta A, et al. Long-term outcome of epididymectomy for the management of chronic epididymal pain. J Urol . 2009 Oct;182(4):1407-1412.
The Merck Manual of Diagnosis & Therapy . 17th ed. Rahway, NJ: Merck & Co; 1999.
Santillanes G, Gausche-Hill M, et al. Are antibiotics necessary for pediatric epididymitis? Pediatr Emerg Care . 2011 Feb 19.
- Reviewer: Mohei Abouzied, MD
- Review Date: 09/2013
- Update Date: 09/30/2013