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Medically reviewed by Last updated on Aug 31, 2022.

What is epididymo-orchitis?

Epididymo-orchitis is inflammation of your epididymis and testicle. The epididymis is a coiled tube inside your scrotum. It stores and carries sperm from your testicles to your penis. Epididymo-orchitis usually affects the epididymis and testicle on one side, but it may affect both sides.

Male Reproductive System

What causes epididymo-orchitis?

  • A urinary tract infection (UTI) or mumps virus infection that spreads to the epididymis
  • Trauma or injury of the testes
  • Urine that flows backward from your urethra to the epididymis
  • Sexually transmitted infections (STIs) such as gonorrhea or Chlamydia
  • Use of heart medicine called amiodarone

What are the signs and symptoms of epididymo-orchitis?

  • Pain or tenderness in your scrotum, abdomen, or groin
  • Redness or swelling of your scrotum
  • Pain or burning during urination, or frequent urination
  • Discharge from your penis or blood in your urine or semen
  • Fever

How is epididymo-orchitis diagnosed?

Your healthcare provider may examine your penis, prostate, and scrotum. Your provider may ask about your symptoms and any health conditions you have. You may need any of the following tests:

  • Blood and urine tests may be done to check for infection. If you have discharge, a small amount of this fluid will be tested for bacteria.
  • An ultrasound uses sound waves to show pictures of your testicles on a monitor. An ultrasound may be used to check blood flow to your testicles.
  • A nuclear scan checks the blood flow in your testicles. A small amount of radioactive material may be injected into your blood. The radioactive material helps your blood vessels show up better.

How is epididymo-orchitis treated?

Treatment depends on the cause of your epididymo-orchitis and may include any of the following:

  • Antibiotics help treat a bacterial infection.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Surgery may be needed if your condition gets worse. Surgery to drain an abscess (collection of pus) may be needed. Surgery to remove part or all of your epididymis or testicle may also be done.

How can I manage epididymo-orchitis?

  • Apply ice on your testicles for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Rest in bed as directed. Elevate your scrotum when you sit or lie down to help reduce swelling and pain. You may be asked to do this by placing a rolled-up towel under your scrotum.
  • Scrotal support may be recommended. An athletic supporter provides scrotal support and may make you more comfortable when you stand. Ask your healthcare provider how to use an athletic supporter.
  • Do not lift heavy objects. You can make swelling worse if you lift heavy objects or strain.

When should I seek immediate care?

  • You have severe pain in your testicles.
  • Your symptoms become worse even after you start treatment with medicine.

When should I contact my healthcare provider?

  • Your symptoms do not get better within 3 days of treatment or come back after treatment.
  • You have a hot, red, tender area on your testicles.
  • You have questions or concerns about your condition or care.

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 healthcare providers 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.

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