At the back of each testicle is a coiled tube called the epididymis that stores and carries sperm.
When this tube become inflamed (painful, warm and swollen), it's known as epididymitis.
The cause of epididymitis is usually an infection, and antibiotics may be needed. It might take several weeks for the symptoms to get better.
If the testicles are also inflamed, it's known as epididymo-orchitis.
What are the symptoms of epididymitis?
Epididymitis causes sudden pain in one or both of the testicles. The scrotum will feel tender, warm and swollen.
There may be a build-up of fluid around the testicle (a hydrocele), which will feel like a lump or swelling.
Sometimes there may also be a discharge from the tip of the penis. This means the cause may be a sexually transmitted infection (STI).
Sometimes, it becomes difficult to pee, or you need to pee more often. This means the cause may be a urinary tract infection.
See your GP if you think you have these symptoms, so the cause can be properly diagnosed and treated.
It can be difficult to tell whether testicular pain is the result of epididymo-orchitis, or a much more serious condition called testicular torsion.
Testicular torsion means that the spermatic cord (cord that supplies the testicles with blood) has become severely twisted. It needs very urgent treatment, so if you have any doubt about the cause of your testicular pain, make sure you're seen by a doctor as soon as possible.
What causes epididymitis?
Epididymitis is usually caused by:
- a sexually transmitted infection such as chlamydia or gonorrhoea, or
- a urinary tract infection (UTI)
UTIs are much less common in men than women. In men, a UTI may be caused by an enlarged prostate gland pressing on the bladder, the insertion of a catheter into the penis, or recent surgery to the groin, prostate gland or bladder.
Men of any age can develop epididymitis.
More unusual causes
More unusually, epididymitis is caused by:
- taking high daily doses of the medication amiodarone (normally taken for a heart rhythm disorder)
- urine flowing back into the epididymis after heavy lifting or straining, or associated with an enlarged prostate gland
- a groin injury
- Behçet's disease
When the cause isn't known, it's termed idiopathic epididymitis.
How is it diagnosed?
Your GP will probably need to carry out a physical examination of your groin, to check for signs of inflammation and infection.
To find out the underlying cause of the epididymitis, you may need to have:
- a test for gonorrhea and chlamydia , where a narrow swab is inserted into your penis to collect a sample of discharge
- urine and blood tests
- rectal examination, where your GP inserts a gloved finger into your bottom, to see if there's a problem with your prostate gland
- an ultrasound , to rule out testicular torsion (a medical emergency where the testicle becomes twisted)
How is it treated?
Rest and painkillers
If you've been diagnosed with epididymitis, you'll need to rest and take over-the-counter painkillers to manage any pain. Ibuprofen may be recommended, as this also eases the inflammation.
It may help to:
- lie in bed with your scrotum raised
- wear a scrotal support
- hold a cold pack to your groin (try a pack of frozen peas wrapped in a tea towel)
If the underlying cause is an infection, you may need antibiotics. Read about the:
If you have gonorrhoea or chlamydia, you'll need to avoid having sex until you and your partner have completed treatment for this.