Epididymitis is inflammation (swelling and irritation) of the epididymis, a tube at the back of the testicle that carries sperm. This swelling can cause intense pain in the testicle. It can occur in men of any age, though it happens most often in men between the ages of 14 and 35. There are an estimated 600,000 cases of epididymitis in the United States each year.
Most cases of epididymitis are caused by an infection, usually by the bacteria Mycoplasma or Chlamydia. These infections often come by way of sexually transmitted diseases. The bacterium E. coli can also cause the condition. Other infections, including with the mumps virus and, rarely, tuberculosis, can also cause epididymitis.
Sometimes epididymitis occurs when urine flows backward into the epididymis. This can happen as a result of heavy lifting. Other causes of epididymitis include:
Symptoms of epididymitis include:
To diagnose epididymitis, the doctor will do a physical exam, and will examine the scrotum to look for a tender area or lump. The doctor may also order a urinalysis (urine test) to look for bacteria in the urine. In some cases, doctors use an imaging test called an ultrasound to examine the scrotum.
Epididymitis caused by bacteria is treated with antibiotics, most often doxycycline (Oracea®, Monodox®), ciprofloxacin (Cipro®), levofloxacin (Levaquin®), or trimethoprim-sulfamethoxazole (Bactrim®). Antibiotics are usually taken for 1 to 2 weeks.
Men who have epididymitis can also relieve their symptoms by:
If epididymitis is not treated, complications can develop, including an abscess (pus-filled sac) in the scrotum. The scrotum’s skin may open because of swelling and infection.
In rare cases, epididymitis can cause fertility problems in men. Early diagnosis and treatment can help prevent these complications.
You can reduce your risk of developing epididymitis by:
Epididymitis usually does not cause any long-term problems. Most men who are treated for the condition start to feel better after 3 days, though discomfort and swelling may last weeks or even months after finishing antibiotic treatment.
It is important to finish the entire treatment recommended by your doctor. If symptoms return, follow up with your doctor. Follow-up can rule out other conditions, including a tumor or testicular cancer.
Call your doctor if you develop any symptoms of epididymitis. If your doctor confirms that your infection comes from a sexually transmitted disease, be sure to let recent sex partners know so that they can be examined and treated.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 02/07/2018