Epididymitis

(Epididymo-orchitis)

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

Definition

Epididymitis is inflammation of the epididymis. The epididymis is a tiny tubule on the back of the testicle. It stores sperm and makes a path for sperm to pass out of the body.

Epididymitis may be:

  • Acute—short term, when treated
  • Chronic—lasts longer than 6 weeks, or keeps coming back (less common)

The Epididymis

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Causes

Epididymitis is often caused by an infection. It can also be caused by an injury. Sometimes the cause is not known.

Risk Factors

This condition is more common in men from 20 to 30 years old. However, it can affect males of any age.

Things that may raise the risk are:

  • Having sex, especially anal sex
  • Urinary tract infections
  • STIs , such as chlamydia and gonorrhea
  • Prostate problems or procedures
  • Sitting or cycling for a long time
  • Trauma
  • Infections like tuberculosis and mumps
  • Amiodarone—a heart rhythm drug

Symptoms

Symptoms depend on the cause. They may be:

  • Fever or chills
  • Pain:
    • In one or both testes
    • That may spread to the groin
    • While urinating
    • During sex or ejaculation
  • Hardness or a lump in the testicle
  • Sudden redness or swelling of the scrotum
  • Discharge from the penis
  • Lower belly discomfort

Symptoms of chronic epididymitis may start gradually.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor may suspect epididymitis based on the exam. Tests may be done to look for the cause. They may include:

  • Urine tests and culture
  • Urethral swab
  • Blood and tissue tests
  • Testicular ultrasound

Treatment

Acute epididymitis goes away with treatment. If untreated, it may become long term (chronic). If chronic, symptoms may come and go, even with treatment.

The goal is to prevent damage to the testicle. The type of treatment depends on the cause. Options include:

  • Rest for 1 to 2 days
  • An athletic supporter—to lift and support the scrotum
  • Medicines, such as:
    • Antibiotics—for infections
    • NSAIDS—to ease swelling and pain

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

Hospital care may be needed for severe symptoms or infection. Surgery may be needed for severe, chronic epididymitis.

Prevention

To reduce the risk of epididymitis, practice safe sex.

RESOURCES:

National Kidney Foundation
https://www.kidney.org/
Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

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

References:

Acute epididymitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-epididymitis. Accessed March 16, 2021.
Epididymitis and orchitis. Urology Care Foundation website. Available at: https://www.urologyhealth.org/urology-a-z/e/epididymitis-and-orchitis#. Accessed March 16, 2021.
Lynch S. Acute epididymitis. JAAPA. 2018;31(3):50-51.
McConaghy, JR, Panchal, B. Epididymitis: an overview. Am Fam Physician. 2016 Nov 1;94(9):723-726.
2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/std/tg2015/default.htm. Accessed March 16, 2021.
Last reviewed January 2021 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 3/16/2021

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