Understanding epididymitis

Symptoms of epididymitis

Recognizing epididymitis symptoms is key to early detection and getting effective treatment.

Common epididymitis symptoms include:

• Blood in your semen
• Fever
• Chills
• Painful urination (dysuria)
• Pain in your scrotum
• Swelling and redness of the testicle

Less common symptoms are:

• Burning sensation during urination
• Pain in your groin area
• Testicle pain that intensifies during a bowel movement
• Pain during ejaculation

If you are experiencing any symptoms of epididymitis, contact your urologist to schedule an appointment.

Epididymitis symptoms are similar to testicular torsion, an emergency condition where blood flow is cut off to the testicle due to the twisting of the spermatic cord. Testicular torsion requires emergency surgery to save the testicle.

If you notice blood in your semen or experience nausea and vomiting that’s accompanied by swelling on one side of the scrotum, seek emergency care.

Chronic epididymitis vs. acute epididymitis

Epididymitis can be acute or chronic. Acute epididymitis is often caused by a bacterial infection or STI and typically goes away with treatment.

Chronic epididymitis lasts longer than six weeks and keeps reoccurring, even after treatment. Symptoms develop slower with chronic epididymitis and can take more time to notice.

Common epididymitis causes

Epididymitis can stem from various causes. However, the spread of a bacterial infection is the most common cause.

Sexually transmitted infections such as chlamydia and gonorrhea are often the cause in younger men. In older men, it is more commonly caused by the growth of bacteria.

Other factors that increase your risk of epididymitis include:

• Recent surgery, including prostate, urethra or bladder surgery
• Use of a catheter
• Enlarged prostate (Benign prostatic hyperplasia)
• Blockage in your urethra
• Severe groin injury

Epididymitis can spread through sexual contact. However, you can get epididymitis through the spread of other infections such as a UTI or bladder infection.

Diagnosing epididymitis

Your provider will perform a physical exam to determine if you have epididymitis. They will review your medical history and examine your scrotum to check for tenderness or lumps. They may also do a rectal exam to check for enlargement of the prostate gland.

Other tests your provider may use for an epididymitis diagnosis include:

• STI screening: This test involves inserting a narrow swab into the end of your penis to collect a sample of discharge to check for chlamydia and gonorrhea.
• Urine and blood tests: These tests are used to check for bacteria in the blood and urine.
• Ultrasound: A picture is taken of your testicle to rule out testicular torsion or check blood flow to the testicle.

Effective epididymitis treatment options

Treatment for epididymitis often includes the use of antibiotics and relieving discomfort. If your epididymitis is caused by an STI, your sexual partners should also be treated.

Your provider may also prescribe pain medications or recommend over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen.

Other measures you can take to relieve discomfort are:

• Lying down and keeping the scrotum elevated
• Placing ice packs on the painful area
• Wear supportive underwear

Your provider will schedule a follow-up exam to make sure the infection has gone away.

Epididymitis prevention and self-care tips

To reduce your risk of epididymitis, you can develop healthy habits and practice safe sex. Best practices include:

• Using a condom during sex
• Maintaining good hygiene
• Treat urinary tract infections promptly
• Avoiding strenuous lifting
• Minimizing prolonged periods of sitting