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Acute epididymitis is an inflammation of the epididymis. This is a structure that surrounds and attaches to each testicle. It is shaped like a tube. The epididymis helps transport and store sperm cells.
Chronic epididymitis causes discomfort or pain in the epididymis. It can last for 3 months or longer. This type is less common.
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This condition is most often caused by a bacterial infection. For example:
- Urinary tract infection
- Sexually transmitted diseases (STDs), such as chlamydia and gonorrhea
- Infection of the urethra—urethritis
- Infection of the prostate—prostatitis
Other causes include:
Only men can develop this condition. It affects men age 15-30 with sexually transmitted bacteria begin a common cause. It also affects men over 60 with urinary tract infections being a common cause.
Other factors that increase the risk of epididymitis include:
- 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
Children and newborns can get epididymitis.
Symptoms usually develop within 1 day. These 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
- 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
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Urine culture
- Culture or other test of discharge from penis
- Blood tests
Images may be taken of your scrotum. This can be done with ultrasound.
Treatment is essential to prevent the infection from worsening. Treatment may include:
- 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.
- 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.
- Warm baths—Taking baths can ease the pain and help relieve swelling.
- Surgery—This may be needed in severe cases that keep coming back.
The following steps can help decrease your risk:
- Practice safe sex. Protect yourself from STDs by using condoms .
- Empty your bladder as soon as you feel the need.
National Kidney Foundation
Urology Care Foundation
The Kidney Foundation of Canada
Acute epididymitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114552/Acute-epididymitis. Accessed May 23, 2016. Accessed September 23, 2016.
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 guide: 2006. MMWR. 2006;55. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/treatment/2006/rr5511.pdf. Accessed August 31, 2015.
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.
Santillanes G, Gausche-Hill M, et al. Are antibiotics necessary for pediatric epididymitis? Pediatr Emerg Care. 2011 Feb 19.
- Reviewer: Mohei Abouzied, MD, FACP
- Review Date: 09/2016
- Update Date: 09/24/2014