Pregnancy SmartSiteTM

Skip Navigation Schedule An Appointment

Normal Pregnancy

Staying Healthy

Alcohol and pregnancy Managing your weight gain in pregnancy Steps to take before you get pregnant When you need to gain more weight during pregnancy

What to expect during pregnancy

Aches and pains during pregnancy Choosing the right practitioner Common symptoms during pregnancy Hyperemesis Gravidarum Morning sickness Pregnancy and travel Pregnancy and work Problems sleeping during pregnancy Skin and hair changes during pregnancy Teenage pregnancy

Preparing to go home with your baby

Cribs and crib safety Eat right during pregnancy Preparing your other children

Visits and Tests

Amniocentesis Chorionic villus sampling Genetic counseling before pregnancy Glucose tolerance test-pregnancy Monitoring your baby before labor Nuchal translucency Prenatal care in your first trimester Prenatal care in your second trimester Prenatal care in your third trimester

Epididymitis

Definition

Epididymitis is swelling (inflammation) of the tube that connects the testicle with the vas deferens. The tube is called the epididymis.

Causes

Epididymitis is most common in young men ages 19 to 35. It is most often caused by the spread of a bacterial infection. Infection often begins in the urethra, the prostate, or the bladder. and infections are most often the cause of the problem in young heterosexual men. In children and older men, it is more commonly caused by E coli and similar bacteria. This is also true in men who have sex with men.

Mycobacterium tuberculosis (TB) can cause epididymitis. Other bacteria (such as Ureaplasma) may also cause the condition.

Amiodarone is a medicine which prevents abnormal heart rhythms. This medicine can also cause epididymitis.

The following increase the risk for epididymitis:

  • Recent surgery
  • Past structural problems in the urinary tract
  • Regular use of a urethral
  • Sexual intercourse with more than one partner and not using condoms
  • Enlarged prostate

    • Symptoms

    Epididymitis may begin with:

  • Low
  • Chills
  • Feeling of heaviness in the testicle area

    • The testicle area will get more sensitive to pressure. It will become painful as the condition progresses. An infection in the epididymis can easily spread to the testicle.

    Other symptoms include:

  • Discharge from the urethra (the opening at the end of the penis)
  • Discomfort in the lower abdomen or pelvis
  • Lump near the testicle

    • Less common symptoms are:

  • Pain during ejaculation
  • Pain or burning during urination
  • Painful (epididymis is enlarged)
  • Tender, swollen, and painful groin area on affected side
  • that gets worse during a bowel movement

    • Symptoms of epididymitis may be similar to those of , which requires emergent treatment.

    Exams and Tests

    Physical exam will show a red, tender lump on the affected side of the scrotum. You may have tenderness in a small area of the testicle where the epididymis is attached. A large area of swelling may develop around the lump.

    The lymph nodes in the groin area may be enlarged. There may also be discharge from the penis. A rectal exam may show an enlarged or tender prostate.

    These tests may be performed:

  • Complete blood count ()
  • Doppler
  • Testicular scan (nuclear medicine scan)
  • and culture (you may need to give several specimens, including initial stream, mid-stream, and after a prostate massage)
  • Tests for chlamydia and gonorrhea

    • Treatment

    Your health care provider will prescribe medicine to treat the infection. Sexually transmitted infections need antibiotics. Your sexual partners should also be treated. You may need pain medicines and anti-inflammatory medicines.

    If you are taking amiodarone, you may need to lower your dose or change your medicine. Talk with your provider.

    To ease discomfort:

  • Rest lying down with the elevated.
  • Apply ice packs to the painful area.
  • Wear underwear with more support.

    • You will need to follow-up with your provider to make sure the infection has cleared completely.

    Outlook (Prognosis)

    Epididymitis most often gets better with antibiotic treatment. There are no long-term sexual or reproductive problems in most cases. However, the condition may return.

    Possible Complications

    Complications include:

  • in the scrotum
  • Long-term (chronic) epididymitis
  • Opening on the skin of the scrotum
  • Death of testicular tissue due to lack of blood (testicular infarction)

    • Sudden and severe pain in the scrotum is a medical emergency. You need to be seen by a provider right away.

    When to Contact a Medical Professional

    Contact your provider if you have symptoms of epididymitis. Go to the emergency room or call the local emergency number (such as 911) if you have sudden, severe testicle pain or pain after an injury.

    Prevention

    You can prevent complications if you get diagnosed and treated early.

    Your provider may prescribe antibiotics before a surgery. This is because some surgeries could raise the risk for epididymitis. Practice . Avoid multiple sexual partners and use condoms. This may help prevent epididymitis caused by sexually transmitted diseases.

    References

    Geisler WM. Diseases caused by chlamydiae. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 302.

    Pontari M. Inflammatory and pain conditions of the male genitourinary tract: prostatitis and related pain conditions, orchitis, and epididymitis. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 56.

    Schedule An Appointment

    Contact Atlanta Obsetrics and Gynaecology at The Womens Center Millennium Hospital - 404-ATL-BABY

    GO

    Review Date: 7/4/2022

    Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.