17697 Epididymitis

Overview

Epididymitis is inflammation (swelling) of the epididymis, a coiled tube at the back of each testicle that stores and carries sperm.

It is a common condition, especially in men between 18 and 35 years old.

Epididymitis mainly affects males of any age, but it is most often seen in sexually active younger men, and in older men with urinary tract problems.

Symptoms

Common symptoms

• Pain and swelling in the scrotum or testicle
• Redness or warmth in the scrotum
• Pain or burning during urination
• Discharge from the penis
• Fever or chills

Causes

Main causes

• Bacterial infection, often from a urinary tract infection or a sexually transmitted infection
• Injury or trauma to the groin area
• A urine infection that spreads backwards into the epididymis

Risk factors

• Being sexually active without using condoms
• Having a catheter or recent urinary tract procedure
• A narrow or blocked urine passage
• A history of prostate infection

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe pain in a testicle, seek emergency medical help
• If you have a high fever with testicular pain
• If you are unable to pass urine

Book a routine appointment if:

• If you have persistent discomfort, swelling, or pain that does not resolve
• If you notice a lump or change in the testicle
• If you have painful urination or discharge

Diagnosis

A doctor will ask about your symptoms and medical history, and will examine your scrotum and testicles. They may also press gently on the area to check for pain and swelling.

Tests that may be done

• Urine test to check for infection
• Swab from the penis to test for sexually transmitted infections
• Ultrasound of the scrotum to look at the epididymis and blood flow

What to expect at your appointment

Most men are diagnosed in the doctor's office. The examination may be brief but can cause some discomfort. You may be asked to provide a urine sample or have a blood test.

Treatment

Treatment depends on the cause. Most cases are caused by bacteria and are treated with a course of antibiotics. You will also be advised to rest and manage pain.

Self-care at home

• Rest and elevate the scrotum (for example, by lying down with a towel rolled under)
• Apply a cold pack to the scrotum for short periods to reduce swelling
• Wear supportive underwear or a sports cup
• Take over-the-counter pain relievers, as recommended by your doctor or pharmacist

Medical treatments

A healthcare provider may prescribe antibiotics to treat a bacterial infection. They may also recommend anti-inflammatory medicines to reduce swelling. If an STI is the cause, your partner may also need treatment. Always finish the full course of antibiotics as directed.

When is surgery considered?

Surgery is rarely needed. In severe cases, an abscess (a pocket of pus) may need to be drained. If an anatomical problem causes repeated infections, surgery to correct the blockage may be considered.

Living with this condition

Epididymitis can take several weeks to settle. During this time, rest and gentle care of the scrotum can help. You may need to avoid heavy lifting or strenuous exercise until the pain improves.

Lifestyle tips

• Avoid sexual activity until your symptoms have fully gone
• Stay hydrated to help flush the urinary tract
• Use condoms to reduce the risk of sexually transmitted infections
• Avoid activities that put pressure on the scrotum, such as cycling, until you feel better

Diet and exercise

A balanced diet and good hydration support your immune system while you recover. Gentle walking is fine, but heavy exercise or sports that involve impact should wait until symptoms have cleared.

Mental health and emotional wellbeing

Living with pain in a sensitive area can be stressful and may cause anxiety or low mood. It is normal to feel concerned. Talk to your healthcare team about how you are feeling—they can provide support and guidance.

Prevention

Not always, but you can reduce the risk by practicing safer sex, treating urinary tract infections quickly, and avoiding heavy lifting or strain on the groin.

Vaccines

Vaccination against mumps can help prevent mumps-related epididymitis. Make sure your routine vaccinations are up to date.

Screening programmes

If you are sexually active, regular sexual health check-ups can help detect and treat infections early.

Complications

If left untreated

• Abscess formation in the scrotum
• Spread of infection to the other testicle
• Reduced fertility due to blockage or damage
• Chronic (long-lasting) epididymitis

Long-term outlook

With prompt treatment, most men recover fully within a few weeks. Fertility usually remains normal. Even with complications, many can be successfully managed with medicine or minor procedures. The outlook is very good when treatment starts early.

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