What is Epididymitis?

The epididymis is a coiled tube that sits above and behind both testicles in males, and its job is to store sperm produced by the testicles before ejaculation. When this tube becomes inflamed or infected, a condition called epididymitis can develop.

Epididymitis affects men of all ages and is most commonly caused by a bacterial infection—often sexually transmitted diseases (STDs) like chlamydia or gonorrhea. It is usually accompanied by significant pain and, if left untreated, can lead to further complications or even impact fertility. Here are the basics of epididymitis, including options for treatment and prevention.

Causes and Risk Factors

The cause of epididymitis varies between cases and may depend on age and sexual habits. Some of the causes can include:

STDs: The two most common causes of epididymitis in sexually active men are gonorrhea and chlamydia.
Other infection: Epididymitis can still spread among men who are not sexually active through a nonsexually transmitted bacterial infection. This can happen if a urinary tract infection or prostate infection is present, causing bacteria to spread to the epididymis.
Trauma: Certain groin injuries can cause epididymitis.
Tuberculosis: In rare cases, a tuberculosis infection can lead to epididymitis.
Heart medication: A heart medication called Amiodarone (or Pacerone) can cause inflammation of the epididymis, leading to epididymitis.
Chemical epididymitis: This is a condition where urine flows backward into the epididymis and causes epididymitis. It can be due to extreme straining or heavy lifting in some cases.
Gland enlargement: In some older men, an enlarged prostate gland can lead to a prostate infection, which can, in turn, lead to epididymitis.

In the case of nonsexually transmitted epididymitis, risk factors may include:

History of infections in the prostate or urinary tract
Uncircumcised penis
Prostate enlargement
History of medical procedures in the urinary tract

A few factors can increase the risk of sexually transmitted epididymitis including:

Unprotected sex (sex without a condom)
Personal history of STDs
Partner with an STD

Symptoms and Potential Complications

Symptoms of epididymitis can include:

Pain, tenderness, swelling or redness in the scrotum
Painful urination or ejaculation
Frequent need to urinate
Discharge from the penis
Fever or chills
Blood in semen
Lump on one testicle
Enlarged lymph nodes in the groin
Pain in the lower abdomen

In any cases of pain or swelling in the scrotum, or if you have pain during urination or a discharge from the penis, see your doctor immediately.

When epididymitis goes untreated, lasts longer than six weeks or is recurring, it’s called chronic epididymitis. Other complications can include a pus-filled infection in the scrotum, reduced fertility (in rare cases), or a condition called epididymo-orchitis if the disease spreads to your testicle.

Epididymitis Treatment Methods

Antibiotic medications are the foundation for epididymitis treatment. Because all variants of the condition are related to bacterial infections, they should all respond to antibiotics—although it often takes several weeks for symptoms to disappear entirely. In cases where epididymitis was caused by an STD, your sexual partner will also need a round of antibiotics.

Your doctor may also recommend things like an athletic strap on the scrotum for support and ice packs or pain relievers for mild pain and discomfort. In most cases, you’ll schedule a follow-up to make sure the antibiotics have fully done their job. Epididymitis will typically clear up in about three months.

In certain cases where an abscess has formed in the area, surgery might be required to drain the abscess. There are also times where part, or all, of the epididymis will need to be removed during surgery.

STDs and Prevention

Sexually transmitted varieties of epididymitis can be prevented. Practicing safe sex, including condom usage, can help protect against the STDs that cause complications. In cases where the cause was not related to an STD, or if you have questions about the right safe sex practices to observe to avoid epididymitis, speak to your doctor.