Epididymitis and Epididymo-orchitis

Reviewed/Revised Jan 2024
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The testicles are the pair of organs that sit in the sac below the penis. The epididymis is the coiled tube on top of each testicle where sperm are moved from the testicle and stored.

What are epididymitis and epididymo-orchitis?

Epididymitis is painful inflammation of the epididymis.

Epididymo-orchitis is painful inflammation of both the epididymis and testicle.

  • Epididymitis and epididymo-orchitis usually start from a bacterial infection

  • Doctors treat these disorders with antibiotics

Male Reproductive Organs

What causes epididymitis and epididymo-orchitis?

Epididymitis and epididymo-orchitis are usually caused by a bacterial infection. The infection can be caused by:

Sometimes, you can get epididymitis or epididymo-orchitis without having an infection. Doctors think this may be caused by some urine flowing backward and causing irritation.

What are the symptoms of epididymitis and epididymo-orchitis?

The symptoms of epididymitis and epididymo-orchitis are:

  • Swelling and tenderness near one of the testicles

  • Pain, which can be constant and severe

  • Sometimes, feeling sick and throwing up

  • Sometimes, fever

Pain from epididymitis usually comes on gradually. Pain from epididymo-orchitis usually comes on more rapidly.

If you have a sexually transmitted infection (STI), you may also have other symptoms, such as a discharge (clear, yellow, or green fluid coming out of your penis).

Epididymitis and epididymo-orchitis usually get better fast with treatment. But sometimes inflammation can happen again or last several weeks (chronic epididymitis).

How can doctors tell if I have epididymitis or epididymo-orchitis?

Doctors suspect epididymitis or epididymo-orchitis based on a physical examination. They'll usually also do:

  • A urine test to look for infection

  • Sometimes, ultrasound, to be sure that you don't have a twisted testicle (testicular torsion)

How do doctors treat epididymitis and epididymo-orchitis?

Doctors will have you:

  • Take antibiotics

  • Take pain medicine

  • Rest as much as needed

  • Use ice packs on the painful area

  • Wear a jockstrap (athletic supporter) to support your testicles

If the infection gets worse and you have an abscess (collection of pus), your doctor will do surgery to drain the pus.

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