Pain in The Gonads? Think Epididymitis

Epididymitis (ep-ih-did-uh-MY-tis) is an inflammation of the coiled tube (epididymis) at the back of the testicle that 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.

Symptoms

Signs and symptoms of epididymitis might include:

• A swollen, red or warm scrotum
• Testicle pain and tenderness, usually on one side, that usually comes on gradually
• Painful urination or 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 recurs is considered chronic. Symptoms of chronic epididymitis might come on gradually. Sometimes the cause of chronic epididymitis isn’t identified.

When to see a doctor

Never ignore scrotal pain or swelling, which can be caused by a number of conditions. Some of them require immediate treatment to avoid permanent damage.

If scrotal pain is severe, seek emergency treatment. See a doctor if you have discharge from your penis or pain when you urinate.

Causes

Causes of epididymitis include:

• STIs. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.
• 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 (chemical epididymitis). This condition occurs when urine flows backward into the epididymis, possibly because 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
• A history of STIs

Risk factors for nonsexually transmitted epididymitis include:

• History of prostate or urinary tract infections
• History of medical procedures that affect the urinary tract, such as insertion of a urinary catheter or scope into the penis
• An uncircumcised penis or an anatomical abnormality of the urinary tract
• Prostate enlargement, which increases the risk of bladder infections and epididymitis

Complications

Complications of epididymitis include:

• Puss-filled infection (abscess) in the scrotum
• Epididymo-orchitis, if the condition spreads from your epididymis to your testicle
• Rarely, reduced fertility

Prevention

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

If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor might discuss with you other ways of preventing a recurrence.