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What is epididymitis?

Epididymitis is inflammation of your epididymis. The epididymis is a long curled tube inside your scrotum. It stores and carries sperm from your testicles to your penis. Acute epididymitis lasts for 6 weeks or less and becomes chronic if it lasts longer than 3 months.

Subsequent Epididymitis

What causes epididymitis?

  • Infections: These include urinary tract infections, sexually transmitted infections (STIs), or infections that have spread from your prostate.
  • Medicine: Certain medicines may irritate the lining of your epididymis and cause pain and swelling. Ask for more information on medicine that can cause this.
  • Trauma: An injury to your scrotum or a catheter or other objects placed into your urethra or bladder may cause the condition.

What increases my risk of epididymitis?

  • Sexual activity: Multiple sex partners, sex without using condoms, and anal sex increase the risk of STIs, which may cause epididymitis.
  • Medical or health conditions: Conditions such as an enlarged prostate, cancer, or other conditions that cause pressure or restrict urine flow may increase your risk. This also includes diabetes or a weak immune system.
  • Vasectomy: During this procedure, the epididymis or the blood vessels and nerves around it may become inflamed.

What are the signs and symptoms of epididymitis?

  • Redness, pain, or swelling of your scrotum
  • A burning feeling when you urinate or frequent urination
  • Discharge from your penis or blood in your semen
  • Pain while having sex or trouble having or keeping an erection
  • Abdominal, back, muscle, or joint pain
  • Fever
  • Nausea and vomiting

How is epididymitis diagnosed?

Your healthcare provider will examine your penis and scrotum. He may also check your prostate by inserting a gloved finger into your anus. He may ask about other health conditions you may have. Tell him how long you have had symptoms. Tell him about injuries, trauma, or treatments you have had. He may ask about your sexual partner to see if you are at risk for an STI. You may need any of the following tests:

  • Lab tests: Blood and urine tests may be done to see if you have an infection. If you have discharge, a small amount of this fluid will be collected and sent to a lab for testing.
  • Ultrasound: An ultrasound uses sound waves to show pictures of your scrotum on a monitor. An ultrasound may show bleeding, lumps, or problems with blood flow.
  • Nuclear scan: This test uses a small amount of radioactive material injected into your blood. A monitor will be used to look at your testicles to check blood flow. The radioactive material helps your blood vessels show up better.
  • Surgery: Your healthcare provider may make an incision and open your scrotum to look for the cause of your epididymitis. Tissue samples may be taken and sent to a lab for tests.

How is epididymitis treated?

Your treatment will depend on the cause of your condition and may include any of the following:

  • Antibiotics: This medicine is given if epididymitis is caused by a bacterial infection. Take them as directed.
  • NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your healthcare provider which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
  • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.
  • Surgery: You may need surgery if your condition worsens or becomes chronic. Surgery to remove your epididymis or testicle may be done. You may also need surgery to treat the problem that is causing your condition, such as a urinary tract problem.

What are the risks of epididymitis?

Even with treatment, your condition may get worse and become chronic. Surgery may cause bleeding or lead to an infection. If not treated, epididymitis may cause increased pain. If you have an infection, it may spread to other tissue or cause an abscess (collection of pus). It may also spread to other parts of your body. An infection of your blood can cause severe illness and may be life-threatening.

How can I manage or prevent epididymitis?

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your swollen testicle or scrotum for 15 to 20 minutes every hour as directed.
  • Rest: Rest or decreased activity may help decrease your pain. It may also help you heal faster. Return to normal activities as directed.
  • Safe sex: Use a latex condom during oral, vaginal, or anal sex. Do not have sex with someone who has an STI. If you have an infection, let your sexual partner know so they can be checked for an STI and treated if needed. Do not have sex while you or your partner is being treated for an STI, or until your healthcare provider says that it is okay.
  • Scrotal support: You may be told to put a pillow or rolled up towel under your scrotum to elevate your scrotum when you sit or lie down. This may help reduce your pain. An athletic supporter may make you more comfortable when you stand.

When should I contact my healthcare provider?

  • You have a fever.
  • Your signs and symptoms do not improve within 3 days of treatment or come back after treatment.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel lightheaded or you have fainted.
  • You have severe pain in your testicles that starts suddenly or follows an injury.
  • Your symptoms become worse even after you start treatment with medicine.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.