Epididymitis and epididymo-orchitis are usually caused by a bacterial infection. Infection can result from surgery, the insertion of a catheter into the bladder, or the spread of infections from elsewhere in the urinary tract Overview of Urinary Tract Infections (UTIs) In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body (urethra) contains no bacteria... read more . Sometimes, the cause is a sexually transmitted disease Overview of Sexually Transmitted Diseases (STDs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted diseases may be caused... read more . Rare causes include infection by certain viruses or fungi.
Sometimes there is no infection of any kind. In such cases, doctors believe the epididymis becomes inflamed by reverse flow of urine into the epididymis, perhaps because of straining (as when men lift something very heavy).
Symptoms of epididymitis and epididymo-orchitis include
The pain may become constant and severe. If the cause is a sexually transmitted disease, a discharge may be present. Rarely, an abscess (collection of pus) that feels like a soft lump develops in the scrotum.
Epididymitis and epididymo-orchitis are diagnosed by physical examination and urinalysis. Doppler ultrasonography Doppler ultrasonography Ultrasonography uses high-frequency sound (ultrasound) waves to produce images of internal organs and other tissues. A device called a transducer converts electrical current into sound waves... read more is sometimes used to assess blood flow to the testes.
Epididymitis and epididymo-orchitis are usually treated with antibiotics taken by mouth, bed rest, pain relievers, and ice packs applied to the scrotum. Immobilizing the scrotum with a jockstrap decreases pain from repetitive, minor bumps.
Abscesses usually require surgical drainage.