Overview

Epididymitis (ep-ih-did-uh-MY-tis) is an inflammation of the coiled tube, called the epididymis, at the back of the testicle. The epididymis stores and carries sperm. Males of any age can get epididymitis.

Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — a condition called epididymo-orchitis.

Epididymitis is usually treated with antibiotics and measures to relieve discomfort.

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Symptoms

Symptoms of epididymitis might include:

  • A swollen, discolored or warm scrotum
  • Testicle pain and tenderness, usually on one side, that often comes on slowly
  • Pain when you pass urine
  • An urgent or frequent need to urinate
  • Discharge from the penis
  • Pain or discomfort in the lower abdomen or pelvic area
  • Blood in the semen
  • Less commonly, fever

Chronic epididymitis

Epididymitis that lasts longer than six weeks or that happens over and over again is considered chronic. Symptoms of chronic epididymitis might come on slowly. Sometimes the cause of chronic epididymitis isn't able to be found.

When to see a doctor

Don't ignore scrotal pain or swelling. This can be caused by a number of conditions. Some of them need treatment right away to avoid permanent damage.

If you have severe pain in the scrotum, seek emergency treatment. If you have discharge from your penis or pain when you pass urine, see a health care provider.

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Causes

Causes of epididymitis include:

  • STIs. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active males.
  • Other infections. Bacteria from a urinary tract or prostate infection might spread from the infected site to the epididymis. Also, viral infections, such as the mumps virus, can result in epididymitis.
  • Urine in the epididymis. This condition occurs when urine flows backward into the epididymis, causing chemical irritation. It may be the result of heavy lifting or straining.
  • Trauma. A groin injury can cause epididymitis.
  • Tuberculosis. Rarely, epididymitis can be caused by tuberculosis infection.

Risk factors

Certain sexual behaviors that can lead to STIs put you at risk of sexually transmitted epididymitis, including having:

  • Sex with a partner who has an STI
  • Sex without a condom
  • Anal sex
  • A history of STIs

Risk factors for epididymitis that's not sexually transmitted include:

  • Having a prostate or urinary tract infection
  • Having a medical procedure done that affects the urinary tract, such as insertion of a urinary catheter or scope into the penis
  • An uncircumcised penis
  • A difference in the typical anatomy of the urinary tract
  • Prostate enlargement, which increases the risk of bladder infections and epididymitis
  • Other health conditions that cause a weakened immune system, such as HIV

Complications

Complications of epididymitis include:

  • Pus-filled infection, called an abscess, in the scrotum
  • Collection of fluid around the testicle, called a hydrocele
  • Epididymo-orchitis, if the condition spreads from the epididymis to a testicle
  • Rarely, reduced fertility

Prevention

To help protect against STIs that can cause epididymitis, practice safer sex.

If you have recurrent urinary tract infections or other risk factors for epididymitis, your health care provider might talk with you about other ways you can help prevent the condition.

Dec. 09, 2022
  1. Sexually transmitted infections treatment guidelines, 2021: Epididymitis. Centers for Disease Control and Prevention. https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm. Accessed Sept. 7, 2022.
  2. Epididymitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/epididymitis#. Accessed Sept. 7, 2022.
  3. Khastgir J. Advances in the antibiotic management of epididymitis. Expert Opinion on Pharmacotherapy. 2022; doi:10.1080/14656566.2022.2062228.
  4. Ferri FF. Epididymitis. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Sept. 7, 2022.
  5. Eyre RC. Acute scrotal pain in adults. https://www.uptodate.com/contents/search. Accessed Sept. 7, 2022.
  6. Eyre RC. Nonacute scrotal conditions in adults. https://www.uptodate.com/contents/search. Accessed Sept. 7, 2022.
  7. Lynch S. Acute epididymitis. Journal of the American Academy of Physician Assistants. 2018; doi:10.1097/01.JAA.0000530304.69021.4b

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