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)
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Epididymitis is often caused by an infection. It can also be caused by an injury. Sometimes the cause is not known.
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:
Symptoms depend on the cause. They may be:
- Fever or chills
- 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.
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
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.
To reduce the risk of epididymitis, practice safe sex.
- Acute epididymitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-epididymitis.
- Epididymitis and orchitis. Urology Care Foundation website. Available at: https://www.urologyhealth.org/urology-a-z/e/epididymitis-and-orchitis#.
- 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.
- Mohei Abouzied, MD, FACP
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