Navigate Up

Heart Center - A-Z Index

#
J
Q
X
Z

Print This Page

Epididymitis

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. Gonorrhea and chlamydia infections are most often the cause 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 homosexual men.

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

Another cause of epididymitis is the use of a medicine called amiodarone, which prevents abnormal heart rhythms.

The following increase the risk for epididymitis:

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

Symptoms

Epididymitis may begin with a low fever , chills, and a feeling of heaviness in the testicle area. The area will get more sensitive to pressure and become painful as the condition progresses. An infection in the epididymis can easily spread to the testicle.

Other symptoms include:

  • Blood in the semen
  • Discharge from the urethra (the opening at the end of the penis)
  • Discomfort in the lower abdomen or pelvis
  • Fever
  • Lump near the testicle
  • Pain during ejaculation
  • Pain or burning during urination
  • Painful scrotal swelling (epididymis is enlarged)
  • Tender, swollen, and painful groin area on affected side
  • Testicle pain that gets worse during a bowel movement

Exams and Tests

Physical exam will show a red, tender lump on the affected side of the scrotum. Tenderness is most often centered 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 also be enlarged, and there may be discharge from the penis. A rectal exam may show an enlarged or tender prostate.

These tests may be performed:

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

This condition may appear like testicular torsion , in which the blood supply to the testicle is cut off. It is important to make the distinction because testicular torsion is an emergency. Surgery is needed as soon as possible in a case of testicular torsion..

Treatment

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

If the condition is caused by taking amiodarone, you will need to lower your dose or change your medicine.

To ease discomfort:

  • Rest lying down with the scrotum elevated.
  • Apply ice packs to the painful area.

You will need to follow up with your health care 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:

  • Abscess in the scrotum
  • Chronic epididymitis
  • Opening on the skin of the scrotum
  • Death of testicular tissue due to lack of blood (testicular infarction)
  • Infertility

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

When to Contact a Medical Professional

Call your health care 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 from epididymitis by getting diagnosed and treated early.

Your doctor may prescribe antibiotics before a surgery that could raise the risk for epididymitis. Practicing safe sex (including avoiding multiple sexual partners and using condoms) may help prevent epididymitis caused by sexually-transmitted diseases.

References

Geisler GM. Diseases caused by chlamydiae. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 326.

Nickel JC. Inflammatory conditions of the male genitourinary tract: Prostatitis, and related conditions, orchitis, epididymitis. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 11.

Updated: 9/29/2014

Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com