Epididymitis: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Avinash Gottumukkala , Urologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Epididymitis is an inflammation of the epididymis, the coiled tube located behind the testicle that stores and transports sperm. It is most commonly caused by bacterial infections, including sexually transmitted infections (STIs) such as chlamydia and gonorrhea in younger men, or urinary tract infections in older adults. Symptoms typically include scrotal pain and swelling, tenderness, redness, fever, painful urination, and, in some cases, discharge from the penis. Early diagnosis and prompt treatment with appropriate antibiotics and supportive care are essential to relieve symptoms, prevent complications such as abscess formation or infertility, and preserve reproductive health.

What are the Types of Epididymitis?

Epididymitis is an inflammation of the epididymis, the tube that stores and carries sperm. There are different types of epididymitis, classified based on the underlying cause:

Acute Epididymitis: This is the most common type, characterized by a sudden onset of pain and swelling in the testicle. It is typically caused by bacterial infections, particularly from sexually transmitted infections (STIs) like chlamydia and gonorrhea, or urinary tract infections (UTIs).
Chronic Epididymitis: Chronic epididymitis is a long-lasting inflammation that can develop after an acute infection or as a result of other factors like ongoing infection, trauma, or the use of certain medications. Symptoms may be less intense but persistent and can include mild to moderate pain and swelling.
Tuberculous Epididymitis: This type occurs when tuberculosis (TB) bacteria infect the epididymis. It is rare and typically seen in individuals with active TB infection elsewhere in the body. This type often presents with chronic pain and swelling.
Non-infectious Epididymitis: This type is not caused by an infection but can result from trauma, autoimmune conditions, or the use of certain medications. The inflammation occurs without the presence of bacteria or viruses.

What are the Symptoms of Epididymitis?

Epididymitis symptoms and signs include:

A bulging, heated, or red scrotum.
Testicular soreness and tenderness often affect one side and develop over time.
Urination that hurts or that is required urgently or frequently.
Penis discharge.
Lower abdominal or pelvic pain or discomfort.
A blemish on the sperm.
Fever (less common).

What are the Causes of Epididymitis?

There are several causes of epididymitis, such as

STIs : In young, sexually active men, chlamydia and gonorrhoea are the leading causes of epididymitis.
STDs : Sexually transmitted infections are also responsible for causing Epididymitis.
Other Infections : The epididymis can become infected with bacteria from prostate or urinary tract infections. Furthermore, epididymitis can be triggered by viral infections such as mumps.
Chemical Epididymitis : This condition emerges when urine flows backwards into the epididymis, often due to heavy lifting or straining.
Physical Injury : Damage to the groin area can lead to epididymitis as well.

When to See a Doctor for Epididymitis?

Anyone with scrotal pain, swelling, redness, fever, or urinary symptoms should seek prompt evaluation by a Urologist or General Physician. Early diagnosis helps prevent serious complications.

You should see a doctor if you experience:

Persistent scrotal pain or swelling.
Painful urination or abnormal penile discharge.
Fever accompanied by scrotal discomfort.

Seek emergency medical attention immediately if you:

Develop sudden, severe testicular pain.
Experience rapidly increasing scrotal swelling with high fever.
Notice severe pain associated with nausea or vomiting, which may indicate testicular torsion.

These symptoms require urgent medical evaluation because delayed treatment can lead to permanent testicular damage.

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How Is Epididymitis Diagnosed?

To diagnose Epididymitis, your physician will examine you for signs of swelling in the testicles on the side that is affected and swelling in the lymph nodes in the groin area. Additionally, a rectal examination might be conducted by your physician to check for any enlargement of the prostate or discomfort.

Your doctor might recommend several tests, including:

STI Test : A small swab will be inserted into the tip of your penis to collect discharge, which will then be analyzed in a lab for signs of chlamydia and gonorrhoea.
Blood and Urine Analysis : Tests will be carried out on your blood and urine to identify any irregularities.
Ultrasound : Your doctor may advise you to have an ultrasound to rule out testicular torsion. If the blood flow to your testicular pain is higher or lower than normal, it would indicate torsion. Ultrasound with colour Doppler can assist in diagnosing this.

What are the Treatment of Epididymitis?

Treating epididymitis and epididymal-orchitis necessitates antibiotics. When a sexually transmitted infection is identified as the cause, your partner must undergo treatment as well. It's essential to finish the full course of antibiotics prescribed by your physician, even if you begin feeling better ahead of schedule.

You're likely to notice an improvement in your condition within 48 to 72 hours of starting antibiotic treatment. To alleviate discomfort, consider lying down, using a jockstrap for scrotal support, applying cold packs, or consuming analgesics.

Your healthcare provider will likely schedule a follow-up visit to verify the epididymitis infection has been fully cleared. Surgical intervention might be needed to drain an abscess if one forms. Additionally, if physical abnormalities are the root of the epididymitis, partially or fully removing the epididymis through surgery (epididymectomy) might become necessary.

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What is the Prevention of Epididymitis?

Prevention of epididymitis involves several key practices to reduce the risk of infection and related complications:

Practice Safe Sex: Use condoms consistently to prevent sexually transmitted infections (STIs), such as chlamydia and gonorrhea, which are common causes of epididymitis.
Good Personal Hygiene: Maintain proper genital hygiene by washing the area regularly and thoroughly to avoid bacterial buildup.
Urinary Health: Stay hydrated and urinate regularly to prevent urinary tract infections (UTIs), which can lead to epididymitis.
Treatment of Prostate Issues: Individuals with a history of prostate problems (like prostatitis) should follow their healthcare provider's recommendations for treatment as these conditions can increase the chance of epididymitis.
Avoid Irritants: Avoid the use of irritants, such as harsh soaps or products that can cause inflammation or infection in the genital area.

What is the Recovery Process for Epididymitis?

Most individuals begin to improve within a few days after starting antibiotics, although complete resolution of swelling may take several weeks. Recovery depends on the severity of the infection, timely treatment, and adherence to the prescribed medications. Untreated Epididymitis may lead to chronic pain or fertility problems.

Completing the full course of antibiotics, resting until symptoms improve, wearing supportive underwear, avoiding sexual activity until treatment is complete when advised, attending follow-up appointments, and seeking prompt care if symptoms worsen help support complete recovery.

Recovery Includes

Completing all prescribed antibiotics.
Resting and limiting strenuous physical activity.
Using scrotal support to reduce discomfort.
Applying cold compresses as recommended.
Attending follow-up appointments.
Monitoring for recurrence or persistent symptoms.

Frequently Asked Questions

1. Can epididymitis be cured?

Yes, it can often be effectively cured with the appropriate medical treatment, primarily antibiotics. Completing the entire prescribed antibiotic course is crucial to ensure the infection is eliminated.

2. How long does epididymitis pain last?

The duration of epididymitis pain varies among individuals. If diagnosed and treated promptly, the pain and discomfort can start improving within a few days to a week. However, complete relief may take a few weeks.

3. Is epididymitis harmful?

Untreated epididymitis can be harmful as it may lead to more severe complications, such as testicle infections or even infertility. It's essential to seek medical attention promptly if you suspect you have the condition to prevent such issues.

4. What is the recovery time for epididymitis?

Recovery time is variable, but with appropriate treatment, many individuals can expect to start feeling better within a few days to a week. Complete recovery may take a few weeks.

5. What is the best antibiotic to treat epididymitis?

The choice of antibiotic for epididymitis depends on the specific bacteria causing the infection. Consult a healthcare professional for personalized treatment.