Epididymitis: Causes, Symptoms, Diagnosis and Treatment

Diagram of the testicles showing epididymitis.

What is Epididymitis?

Epididymitis is the inflammation of the epididymis, a tube found in the testicle that transports sperm. This condition can cause severe testicular pain.

Although epididymitis can occur at any age, it is most commonly found in males between the ages of 14-35 years old. In the US, there are approximately 600,000 cases of epididymitis per year.

What causes epididymitis?

Epididymitis is usually brought about due to infection. Most commonly, it’s caused by the bacteria Mycoplasma or Chlamydia. These infections are often develop from STDs (sexually transmitted disease).

Another bacterium called E.coli can also cause epididymitis. Additionally, this condition can also occur with other infections, such as the mumps virus or (in rare instances) tuberculosis.

In certain cases, epididymitis is caused by urine flowing backwards into the epididymis. This could be caused by heavy lifting.

Epididymitis can also be caused by the following:

  • A blockage of the the tube that transports urine from the body (the urethra).
  • Enlargement or infection of the prostate gland.
  • Using a urinary catheter.
  • Trauma or injury to the groin area.

Epididymitis Symptoms

Epididymitis can be characterized by exhibiting the following symptoms:

  • Pain in the testicle which may spread to the entire groin area.
  • Redness and swelling of the testicle.
  • Painful urination.
  • Elevated body temperature and/or chills.
  • Blood may be present in the semen.

Seeing a Doctor

Your doctor will perform a physical examination in order to diagnose epididymitis. He or she will also examine the scrotum for any soreness or lumps.

A urinalysis (urine testing) may be ordered by the doctor to check for bacteria. Sometimes the doctor may want to examine the scrotum more closely by using an ultrasound imaging test.

What is the Treatment For Epididymitis?

Epididymitis that is caused by bacteria is treated with antibiotics. Antibiotics are typically taken for up to two weeks.

If the cause of the bacterial infection is an STD, your sexual partner will also require treatment. In order to ensure that the infection has completely healed, it’s important to take the entire course of antibiotics prescribed by your doctor, even if your symptoms go away sooner.

You will normally begin to feel better within 48-72 hours after starting your antibiotic treatment. Some other things you can do to help relieve discomfort include:

  • Getting rest.
  • Keeping the scrotum elevated.
  • Applying cold packs to the groin.
  • Using an athletic supporter to support the scrotum.
  • Staying hydrated.
  • Taking over-the-counter anti-inflammatory pain medications.

Your doctor will probably schedule a follow-up appointment to verify that the infection is gone.

What Complications Can Occur From Epididymitis?

If left untreated, epididymitis may develop complications such a pus-filled cyst in the scrotum, called an abscess. Swelling and infection can cause the skin of the scrotum to become open.

If an abscess has formed, it may require surgery in order to drain it. In some cases, all or part of the epididymis has to be surgically removed (a procedure called an epididymectomy).

Surgery may also be considered if the epididymitis is caused by an underlying physical abnormality.

Although rare, epididymitis can also sometimes lead to male fertility problems. However, these complications can often be prevented by early diagnosis and treatment.

Can Epididymitis Be Prevented?

Your chances of developing epididymitis can be reduced by the following these guidelines:

  • Wear a condom during sex.
  • Avoid heavy lifting or strenuous physical activity.
  • Avoid sitting for long periods of time.


Epididymitis rarely causes long-term health problems. The majority of men who have been diagnosed with epididymitis begin to feel better within a few days after starting treatment.

However, discomfort and swelling can still last for weeks or months after finishing treatment with antibiotics.

Be sure to finish the full round of medications prescribed to you, and follow-up with your doctor if any symptoms persist. This can help exclude the possibility of other conditions such as a tumor or testicular cancer.

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