Epididymitis is an inflammation of the coiled tube at the back of the testicle that stores sperm. Males of any age can get epididymitis. Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections, such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — a condition called epididymoorchitis.
What are the symptoms of epididymitis?
Epididymitis may begin with only a few mild symptoms. When it’s left untreated, the symptoms tend to get worse. People with epididymitis may experience:
- low-grade fever
- pressure in the testicles
- pain and tenderness in the testicles
- redness and warmth in the scrotum
- pain during sexual intercourse and ejaculation
- pain during urination or bowel movements
- abnormal penile discharge
- blood in the semen
Two main groups of organisms cause most cases of epididymitis: sexually transmitted organisms and coliforms (organisms that live in the intestines).
- In men younger than about 39 years of age, the causes are usually the same organisms that cause the sexually transmitted diseases of chlamydia and gonorrhea. The bacterial species are Chlamydia trachomatis and Neisseria gonorrhea.
- In those older than 39 years of age, the causes are usually coliforms, which are bacteria that live in the intestines. These organisms also frequently cause bladder infections. Any age of men who participate in anal intercourse are more likely to get infected with E. coli or other fecal bacteria.
- Chemical epididymitis is inflammation caused by the backward flow of urine when exercising or having sex with a full bladder.
The doctor will probably have to carry out a physical exam to see if any of the symptoms of epididymitis are present and to check for signs of infection. It can often be hard to tell the difference between epididymitis and testicular torsion, particularly in younger men. Sometimes epididymitis and testicular torsion can occur at the same time. Doctors may perform some other tests to find the cause. These include:
- rectal exam, where a doctor inserts a finger into the anus to check for an enlarged prostate
- urine and blood tests
- urine samples to test for gonorrhea and chlamydia
- ultrasound scans, to identify testicular torsion
Antibiotics are needed to treat bacterial epididymitis. If the cause of the bacterial infection is an STI, your sexual partner will also need treatment. Take the entire course of antibiotics prescribed by your doctor, even if your symptoms clear up sooner, to ensure that the infection is gone. You should start to feel better within 48 to 72 hours of starting an antibiotic. Resting, applying ice packs and taking pain medication can help relieve discomfort. Your doctor is likely to recommend a follow-up visit to check that the infection has cleared.
It’s important to seek treatment right away in order to prevent complications. You should also see your doctor after you’ve finished the medication to make sure that the infection has cleared. This will help ensure that you make a complete recovery. If you’re experiencing persistent pain or discomfort, make an appointment to see your doctor, especially if the symptoms don’t improve within few days. If you’re experiencing severe pain in the scrotum or have a high fever, make sure to seek medical attention immediately.