Funiculitis

Funiculitis (fyoo-NIK-yuh-lie-tus) is a relatively rare cause of inflammation in your spermatic cord. Your spermatic cord supplies blood to your testicles. It usually appears alongside inflammation in other nearby parts of your body, including your:

• Epididymis (epididymitis)
• Testicles (orchitis)
• Urethra (urethritis)

Spermatic cord inflammation causes swelling, discomfort and pain in and around your scrotum. It can be shocking and downright scary when symptoms affect the more sensitive areas of your body. But inflammation is your body’s way of telling you that something is wrong with your spermatic cord, and you should visit a healthcare provider.

Symptoms of funiculitis

Funiculitis symptoms may include:

• Fever and chills
• Lower abdominal pain
• Nausea and vomiting
• Pain during sexual intercourse (dyspareunia)
• Pain when you pee (dysuria)
• Swelling in your scrotum
• Tenderness in your scrotum

What causes funiculitis?

Bacterial infections (like E. coli) or viral infections (like the mumps virus) are a common cause of funiculitis. These may include a urinary tract infection (UTI) or sexually transmitted infections (STIs). Common STIs that cause funiculitis include:

• Chlamydia
• Gonorrhea

Other funiculitis causes may include:

• Hernia
• Trauma, like a blow to the area or surgery
• Tumors in the area

Different types of funiculitis include:

• Acute (sudden) funiculitis. This is when funiculitis symptoms develop suddenly and get worse. Acute funiculitis is usually the result of a bacterial or viral infection.
• Chronic (long-lasting) funiculitis. This is when you have funiculitis symptoms for six weeks or longer. Pain or discomfort may go away and come back. The symptoms are usually less severe than acute funiculitis. It usually results from recurring infections or abnormalities in your spermatic cord.
• Granulomatous funiculitis. This is when granulomas form in your spermatic cord. It usually results from an autoimmune disease or a specific type of bacterial infection.
• Idiopathic funiculitis. This is when funiculitis symptoms develop without any clear cause.
• Postoperative funiculitis. This is when funiculitis symptoms develop after surgery in the area.

Risk factors

Anyone with a spermatic cord can get funiculitis. But your risk increases if you:

• Have inflammation in your epididymis, testicles and/or urethra
• Have surgery in the area
• Have unprotected sexual intercourse with multiple partners
• Use a Foley catheter
• Use products that may contain irritants, such as spermicides or lubricants (lube)

Complications of funiculitis

In rare cases, funiculitis may cause pus to develop in your spermatic cord or a pocket of pus (abscess) to form. You may need surgery to drain pus.

How doctors diagnose funiculitis

A healthcare provider will review your medical history, ask questions about your symptoms and perform a physical exam to check for tenderness and swelling. They may also recommend additional tests to help determine what’s causing the inflammation so that they can recommend the most appropriate treatment.

Tests that are used

A healthcare provider may recommend the following tests to help diagnose funiculitis and its cause:

• Blood tests. A provider will take a blood sample and look for signs of infection.
• Imaging tests. Providers may suggest noninvasive imaging tests like a pelvic ultrasound or CT scan to see detailed images of your spermatic cord and the surrounding areas.
• Urinalysis (pee test). A urinalysis looks for the presence of bacteria in your pee sample.
• Urine culture. A provider collects a sample of your pee to see if bacteria grow.

How do you treat inflammation of the spermatic cord?

Funiculitis treatment depends on its cause. Common funiculitis treatments include:

• Antibiotics. Antibiotics treat bacterial infections. If an STI causes funiculitis, your sexual partner(s) should also get treatment from a healthcare provider.
• Ice. Wrap ice or a cold pack in a towel and apply it to the area to reduce swelling. Don’t apply ice for longer than 20 minutes at a time.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs help reduce discomfort, inflammation and pain. Check with a provider before you take NSAIDs.
• Rest. It’s a good idea to lie down as often as possible. Elevate your pelvis by placing pillows under your hips and butt (buttocks).
• Scrotal support. A tight pair of supportive underwear (briefs) or a jockstrap can help support your scrotum, including your testes and spermatic cord. This reduces pain that can result from free motion.

What is the surgery for funiculitis?

In rare cases, you may need surgical drainage to remove pus that develops from severe funiculitis. During surgical drainage, a surgeon will make a small incision in your groin to access your spermatic cord. They’ll drain the pus and clean out the abscess with saline solution. In some cases, the surgeon may collect a sample of the pus and send it to a lab to determine which bacteria caused the infection.

You may also need to take a course of antibiotics to make sure the infection doesn’t come back.

Recovery time

Your recovery time depends on the cause. A healthcare provider will give you a better idea of what to expect according to the cause of funiculitis. But in general:

• Bacterial infections should start to feel better a few days after starting antibiotics. Be sure to finish your full course of antibiotics, even if you start to feel better. If you don’t, the infection could come back and be more difficult to treat.
• Physical trauma may take a few days or weeks to feel better.
• Viral infections may take a few weeks to feel better.

When should I see my healthcare provider?

Reach out to a healthcare provider if you develop any funiculitis symptoms. Contact them again if you receive treatment for funiculitis and your symptoms don’t improve.

You may wish to ask a provider the following questions:

• What caused funiculitis?
• Does the inflammation affect my epididymis, testicles or urethra?
• What treatment do you recommend?
• Do you recommend any other testing?
• When should I expect to feel better?
• Is there anything else I can do to relieve my symptoms?
• Should I avoid sexual intercourse?
• Should my sexual partner(s) schedule an appointment for treatment?
• How can I prevent funiculitis in the future?

Can funiculitis be prevented?

You can help reduce your risk of developing funiculitis by:

• Avoiding chemicals that may irritate nearby areas of your body
• Getting all recommended vaccines
• Getting STI tests every three to six months if you’re sexually active
• Practicing safe sex
• Regularly washing your hands with clean water and soap

What can I expect if I have funiculitis?

With proper diagnosis and treatment, the outlook for funiculitis is good. It may be uncomfortable and painful, but it usually doesn’t cause any long-term problems

If an STI causes funiculitis, it’s important to refrain from having sexual intercourse until the infection clears. You should also let your sexual partner(s) know so they can get tested and treatment, if necessary.