Epididymitis

Overview

What is epididymitis?

Epididymitis is inflammation of your epididymis, a coiled tube at the back of your testicle that stores and carries sperm. This swelling can cause intense testicular pain.

What’s the difference between epididymitis and orchitis?

While epididymitis refers to inflammation of the tube at the back of your testicle, orchitis refers to swelling of your testicle itself. Sometimes, these two conditions occur simultaneously. When this happens, it’s called epididymo-orchitis.

Who does epididymitis affect?

Epididymitis can occur at any age, though it happens most often in people between the ages of 14 and 35. Men and people assigned male at birth can develop epididymitis.

How common is epididymitis?

There are an estimated 600,000 cases of epididymitis in the United States each year.

Symptoms and Causes

What are the symptoms of epididymitis?

Epididymitis symptoms may include:

What causes epididymitis?

Most cases of epididymitis are caused by an infection called E. coli. Some cases happen from bacteria called Mycoplasma or Chlamydia. These infections often come by way of sexually transmitted diseases.

Other infections, including the mumps virus and rarely, tuberculosis, can also cause epididymitis.

Sometimes, epididymitis occurs when pee (urine) flows backward into your epididymis. This can happen as a result of heavy lifting. Other epididymitis causes include:

  • Blockage in your urethra (the tube that carries pee from your body).
  • An enlarged or infected prostate gland (a muscular, walnut-sized gland that surrounds part of your urethra).
  • Use of a catheter (a tube that drains your bladder).
  • Surgery on the prostate, urethra or bladder.
  • Traumatic groin injury.

Can you get epididymitis without having an STD?

Yes. You can get epididymitis through nonsexually transmitted infections. For example, prostate or urinary tract infections can spread to your epididymis.

Is epididymitis contagious?

Yes. Epididymis can spread through sexual contact. While epididymitis isn’t categorized as an STD, it’s still a common symptom of many STDs, including chlamydia and gonorrhea.

Diagnosis and Tests

How is epididymitis diagnosed?

To diagnose epididymitis, your healthcare provider will examine your scrotum to look for a tender area or lump. They may also order a urinalysis (urine test) to look for bacteria in your pee. In some cases of epididymitis, ultrasound technology may be used to take diagnostic images of your scrotum.

Management and Treatment

How is epididymitis treated?

Epididymitis treatment involves antibiotics. The most common medications include doxycycline, ciprofloxacin, levofloxacin or trimethoprim-sulfamethoxazole. Antibiotic treatment usually lasts about one to two weeks.

People with epididymitis can also relieve their symptoms by:

What are complications of epididymitis?

If epididymitis isn’t treated, complications can develop, such as an abscess (pus-filled sac) in your scrotum. Your scrotum’s skin may open because of swelling and infection.

In rare cases, epididymitis can cause fertility problems. Early diagnosis and treatment can help prevent these complications.

Will epididymitis go away?

With proper treatment, epididymitis will go away. It’s important to seek treatment as soon as possible to avoid further complications.

What can happen if epididymitis is left untreated?

An epididymitis infection can lead to serious problems if it’s not treated in a timely manner. Chronic epididymitis could cause an abscess to form on your scrotum. Or it could destroy your epididymis, resulting in infertility. In some cases, the infection can spread to other parts of your body.

Does ejaculating hurt epididymitis?

While ejaculating doesn’t make an epididymitis infection worse, it can make the pain more intense for some people. It’s best to abstain from masturbation until you’re treated, and you definitely shouldn’t have sex with anyone until your healthcare provider gives you clearance.

Prevention

How can I reduce my risk for epididymitis?

To reduce your risk of epididymitis, you should:

  • Use condoms during sex.
  • Avoid strenuous lifting or physical activity.
  • Minimize long periods of sitting.

Outlook / Prognosis

What can I expect if I have epididymitis?

If you’ve been diagnosed with epididymitis, your healthcare provider will prescribe an antibiotic regimen to ease your symptoms. They’ll also give you advice on how to relieve discomfort at home.

While epididymitis can be quite painful, it usually doesn’t cause any long-term problems, especially when treated early on.

How long can epididymitis last?

Most people who are treated for epididymitis start to feel better after three days, though discomfort and swelling may last weeks or even months after finishing antibiotic treatment.

It’s important to finish the entire treatment recommended by your healthcare provider. If symptoms return, follow up with your provider. They can rule out other conditions, including a tumor or testicular cancer.

Living With

When should I see my healthcare provider?

Call your healthcare provider if you develop any symptoms of epididymitis. If they confirm that your infection is due to a sexually transmitted disease, be sure to let recent sex partners know so that they can be examined and treated.

Any time you develop sudden or severe testicular pain, call 911 or head to your nearest emergency room.

What questions should I ask my healthcare provider?

If you’ve been diagnosed with epididymitis, you’ll want to learn all you can about your outlook and treatment options. Here are some questions you may want to ask your healthcare provider:

  • What kind of antibiotics do you recommend?
  • Do I need any further testing?
  • How long will it take before I feel better?
  • How long do I need to abstain from masturbation or sex?
  • Should my partner be tested for STDs?

A note from Cleveland Clinic

Epididymitis is inflammation of your epididymis, a tube at the back of your testicle that carries sperm. It can be quite painful and interfere with your everyday life. With proper treatment, the infection will go away and your symptoms will improve. It’s important to take all medications exactly as prescribed and follow your healthcare provider’s recommendations to ensure a comfortable and successful recovery.

Last reviewed by a Cleveland Clinic medical professional on 07/18/2022.

References

  • American Academy of Family Physicians. Epididymitis: What You Should Know. (https://www.aafp.org/afp/2016/1101/p723-s1.html) Accessed 7/18/2022.
  • Centers for Disease Control and Prevention. Epididymitis. (https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm) Accessed 7/18/2022.
  • Urology Care Foundation. What are Epididymitis and Orchitis? (https://www.urologyhealth.org/urology-a-z/e/epididymitis-and-orchitis) Accessed 7/18/2022.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy