Epididymitis overview

Overview

Epididymitis is swelling and inflammation of the epididymis, a small tube at the back of the testicle that stores and carries sperm. It usually causes pain, redness, and swelling in the scrotum.

Yes, epididymitis is a common condition, especially in sexually active men under 35 and in older men with prostate problems.

It affects males of any age, but it is most common in sexually active men aged 15 to 35, and in men over 50 who have an enlarged prostate or other urinary issues.

Symptoms

Common symptoms

• Pain and tenderness in the scrotum, usually on one side
• Swelling and redness of the scrotum
• A feeling of heaviness in the testicle area
• Pain or burning when urinating
• Discharge from the penis (if caused by an STI)

Symptoms in children

• Pain or swelling in the scrotum
• Redness of the scrotum
• Fever or irritability
• Pain when urinating
• Crying or fussiness in babies

Symptoms in older adults

• Similar pain and swelling in the scrotum
• More likely to have urinary symptoms like difficulty passing urine or frequent urination
• May also have fever or general feeling of being unwell

Causes

Main causes

• Bacterial infection – most commonly from a sexually transmitted infection (STI) like chlamydia or gonorrhea, or from a urinary tract infection (UTI)
• Trauma or injury to the groin area
• Backflow of urine into the epididymis (urine reflux) – can happen during heavy lifting or straining

Risk factors

• Unprotected sex with multiple partners
• Having a urinary catheter
• An enlarged prostate or recent prostate surgery
• A condition that blocks the flow of urine, like a bladder stone or stricture
• Engaging in activities that cause urine reflux (heavy lifting, straining)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe scrotal pain – call your local emergency number immediately
• If you have a high fever with swelling and pain
• If you cannot pass urine

Book a routine appointment if:

• If you have any pain, swelling, or redness in the scrotum that lasts more than a day
• If you have a discharge from the penis or burning when urinating
• If you have been treated before and symptoms return

Diagnosis

Your doctor will ask about your symptoms and sexual history, and will examine your scrotum and groin area. They may also perform a simple physical exam called a 'testicular exam' to check for tenderness and swelling.

Tests that may be done

• Urine test (to check for infection or blood)
• Swab test from the penis (to test for STIs)
• Ultrasound of the scrotum – a painless scan that uses sound waves to show the epididymis and testicles, and can rule out other problems like testicular torsion

What to expect at your appointment

The exam may feel uncomfortable but should not be very painful. Your doctor will explain each step. Most tests are done in the office or clinic, and results often come back within a few days. If an STI is found, your partner may also need treatment.

Treatment

Treatment depends on the cause but usually includes antibiotics for bacterial infections, along with self-care to ease pain and swelling. For chronic cases, longer treatment or other approaches may be needed.

Self-care at home

• Rest and avoid heavy lifting or strenuous activity until pain improves
• Apply a cold pack (ice wrapped in a cloth) to the scrotum for 15–20 minutes at a time
• Wear supportive underwear (like briefs or a jockstrap) to reduce movement and pressure
• Take over-the-counter pain relievers – ask your pharmacist or doctor which type is safe for you

Medical treatments

If bacteria cause the infection, your doctor will prescribe antibiotics to take for a week or more. Finish all the medicine even if you feel better. For pain and swelling, your doctor may recommend an anti-inflammatory medicine (like ibuprofen) – always follow their advice on dosage. If an STI is the cause, your sexual partner(s) should be treated as well to prevent re-infection.

When is surgery considered?

Surgery is rarely needed. It may be considered if an abscess (a pocket of pus) forms, or if chronic pain does not improve with other treatments. In such cases, a minor procedure can drain the abscess or remove part of the epididymis.

Living with this condition

During treatment, rest and avoid activities that cause pain. Most people can return to normal activities including work, sports, and sex once the infection clears – usually after finishing antibiotics and when symptoms resolve. Avoid sex until your doctor says it is safe, especially if an STI was involved.

Lifestyle tips

• Practice safe sex (use condoms) to reduce risk of STIs that can cause epididymitis
• Drink plenty of water to help flush out infections
• If you have to lift heavy objects, use proper technique and avoid straining

Diet and exercise

There is no specific diet for epididymitis, but eating a healthy diet can support your immune system. Light exercise like walking is fine once pain subsides, but avoid heavy lifting or cycling until fully healed.

Mental health and emotional wellbeing

Having pain in the groin area can cause worry or embarrassment. It may also affect your sex life or feelings about your body. These feelings are normal. Talk to your doctor or a counselor if you feel anxious or depressed.

Prevention

Many cases can be prevented by avoiding infections. Practice safe sex – use condoms and get tested for STIs if you have new or multiple partners. Treat any urinary tract infections promptly. Avoid activities that cause urine reflux, such as heavy straining without proper breathing.

Vaccines

There is no vaccine specifically for epididymitis, but some vaccines (like the HPV vaccine) can prevent related infections. Ask your doctor about recommended vaccines.

Screening programmes

There is no routine screening test for epididymitis. If you have symptoms, see your doctor. Regular STI testing is advised if you are sexually active with new partners.

Complications

If left untreated

• Chronic epididymitis (long-lasting pain and swelling that is harder to treat)
• Abscess formation (a collection of pus that may need surgical drainage)
• Spread of infection to the testicle (epididymo-orchitis) or to the rest of the body
• Scarring in the sperm tubes, which can lead to reduced fertility
• In rare cases, tissue death (gangrene) if blood flow is reduced

Long-term outlook

With early treatment, most people get better without any long-term problems. Pain and swelling usually improve within a few days of starting antibiotics. Fertility returns to normal for most. Even chronic cases often improve with proper care. Your doctor will work with you to find the best treatment.

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