Epididymitis causes, symptoms and treatment

If you have a pain close to your testicle, it could be due to a fairly common condition called epididymitis.

We look at painful testicle causes, symptoms and treatment options.
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Painful twinge in the testicle area? Don't panic! If you have pain or discomfort close to your testicles, it could be due to a fairly common condition called epididymitis which is easily treatable.

We look at painful testicle causes, symptoms, treatment and recovery options:

What is epididymitis?

The word 'epididymitis' means inflammation of the epididymis, which is a tightly coiled tube that is attached to the side of the testicle. Its job is to carry sperm away from the testicle and into the main piece of tubing (the vas), which leads to the penis.

The epididymis is small, and it's unlikely that you will be able to feel it clearly with your fingers. You may just be able to detect that there's something soft, which is attached to the testicle.

Epididymitis means inflammation of the epididymis, a tightly coiled tube attached to the side of the testicle.

Unfortunately, when germs get into the penis (for instance, during sex with an infected person), they frequently find their way downwards and into the epididymis, where they cause an inflammation. And this is called epididymitis.

In men who have prostate problems, germs may enter the urinary 'piping' as a result of catheterisation and cause epididymitis. And in older males, epididymitis is usually due to a urinary tract infection, and not sex.



Epididymitis symptoms

Epididymitis is most common in young men, for the simple reason that younger males tend to have more sex. Common symptoms include the following:

✔️ The chief symptom is intense pain, usually in one but occasionally in both testicle. As a rule, this pain comes on gradually.

✔️ The scrotum may be warm to the touch, swollen and feel tender.

✔️ If you are fair-skinned, that side of your scrotum may become red.

✔️ You might run a slight temperature and feel under the weather.

✔️ If the infection has affected the urinary passage, you may also experience painful urination and perhaps a discharge from the penis.



When to see your doctor about epididymitis

Any man who has pain in the scrotum should see a doctor for assessment. If possible, go to a sexual health clinic because the staff are experts in epididymitis and similar conditions.

The most important thing at this stage is to make sure that the pain really is due to epididymitis, and not to some other problem, particularly torsion (twisting) of the testicle, which is a surgical emergency. Torsion usually presents with sudden and very severe pain and you should see a doctor immediately.



Epididymitis causes

Epididymitis is caused by germs, usually acquired during sexual intercourse. The most common germ used to be the bacterium that causes gonorrhoea. But in the UK today, it's probable that the most frequent cause is chlamydia.

Men who practise anal sex (as 'penetrators') may end up with the partner's bowel germs in the epididymis – and therefore be at risk of epididymitis.

Epididymitis is caused by germs, usually acquired during sexual intercourse.

In practice, it's usually difficult to identify the offending 'bug' with certainty, because laboratory swabs can't be taken directly from the epididymis. Swabs may however be taken from the urethra (urine tube) and urine and blood tests can also be helpful in making the diagnosis too.



Epididymitis treatment

Epididymitis is usually treated in the following ways:

• Antibiotics

Fortunately, epididymitis responds extremely well to antibiotics, which kill the germs. You will probably be prescribed a combination of two antibiotics to ensure that the treatment is effective against the likely causes including gonorrhoea and chlamydia – for instance, ceftriaxone and doxycycline.

• Painkillers

Painkillers such as paracetamol and ibuprofen can help ease any pain and you will probably find supportive underpants give you the most comfort.



Epididymitis recovery

Following epididymitis treatment you can expect to feel better within a couple of days and completely recovered within a couple of weeks. But you should not have sex until your medical adviser says it's okay to do so.

Your sexual partner (or partners) may well need treatment and should definitely visit a sexual health clinic for a check-up. Please don't have sex until you have completed treatment.

💡 Note: The word 'epididymo-orchitis' means inflammation of the testicle as well as the epididymis. Treatment and diagnosis are very similar to the above.

Where to find a sexual health clinic

For information on epididymitis treatment and where to get tested for STIs, try one of the following resources:



    Last updated: 20-02-2020

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