Epididymitis

What is epididymitis?

Epididymitis is when the tube at the back of your testicles (the epididymis) becomes inflamed and painful – often caused by a bacterial infection. As your body fights the infection you feel pain, heat and swelling in the area.

Epididymitis orchitis or epididymo-orchitis is when the inflammation is also in your testicles. Inflammation of just your testicles is called orchitis, but this is very rare.

What are the symptoms of epididymitis?

Symptoms can vary depending on the cause, but the key symptoms include:

• Pain in one or both testicles. This may start suddenly or be gradual

• Your scrotum (the bag containing your testicles) can be warm, swollen, or tender

• A lump or swelling in your testicle – this is caused by fluid around your testicle called a hydrocele

• Difficulty or pain when you pee

• A white, yellow or green discharge from the tip of your penis

What causes epididymitis?

Epididymitis is most commonly caused by chlamydia or gonorrhoea – two of the most common sexually transmitted infections (STIs). If an STI is the cause of your epididymitis, you may want to let your partner/s know, so that they can get tested too.

Urinary tract infections (UTIs) can also cause epididymitis, although this isn't too common.

Other rarer causes of epididymitis include:

• Mumps or tuberculosis – though these infections are rare in the UK

• An injury to your groin

• Behcet’s disease

How is epididymitis diagnosed?

A doctor will ask questions about how you’re feeling and examine your testicles. The doctor may need to do some tests on your urine to investigate what’s causing your symptoms. If a doctor thinks it’s appropriate you’ll typically be able to start treatment before the results of your tests are back.

How is epididymitis treated?

In the majority of cases where an infection is the cause of your epididymitis, a doctor will likely prescribe antibiotics. Even if you feel better, it’s important that you finish the full course of antibiotics to get rid of your infection.

Epididymitis can be painful. To help with the pain you can take regular paracetamol or ibuprofen. Holding an ice pack or frozen pack of peas wrapped in a tea towel to your groin can also help. Wearing supportive underwear to lift the testicle can also decrease the pain.

How long does epididymitis last?

You should start to feel better after a few days of treatment but it can take longer. Epididymitis recovery time should be less than 2 weeks.

Some people’s symptoms last longer and this is chronic epididymitis. The pain is usually less severe than short-term epididymitis. Your pain may come and go without treatment, but usually, anti-inflammatory drugs or antibiotics can be used to treat it. Chronic epididymitis isn’t fully understood and sometimes a cause can’t be found.

When should I seek help for epididymitis?

See a doctor if:

• You have swollen testicles

• Your testicles have changed shape, or feel different

• You have a lump in your testicles

• One of your testicles is larger than the other

• You have a persistent ache in your testicles

Seek emergency help and go to A&E if:

• You have unbearable pain in your testicle, tummy or groin that starts suddenly

• You may have a twisting of your testicles called testicular torsion. This needs to be seen and treated in a hospital as soon as possible.

What can Livi do?

A Livi healthcare professional can discuss your symptoms, help with STI and UTI testing, and refer you to specialist treatment if necessary.