You may have fever. The whole scrotum can swell and feel painful. If the mumps virus are the cause, pain in the testis can appear up to 7 days after glands in the face swell. An "acute" case is most often caused by an infection from bacteria. The e-coli bacteria are a common cause for infection. A "chronic" case may result after acute epididymitis. It doesn't seem to go away. It can also happen without acute symptoms or known infection.
In this case, the cause is unknown. Orchitis alone is mostly from a mumps virus or other virus infection. In some cases of mumps, interferon can be given to prevent orchitis. This infection doesn't spread to the epididymis. Acute epididymo-orchitis is most often from a bacterial infection.
It can also be caused by a tuberculous infection of the epididymis, but this is rare. Rarely, it can start in the testis and spread to the epididymis.
Your health care provider will ask about your past health and examine you. In acute epididymitis the urine is often infected. In chronic epididymitis the urine typically is not infected. If your provider thinks you have urethritis, they may test a swab of fluid from your urethra.
Ultrasound is a non-invasive test. It uses sound waves bouncing off structures in your body to make a picture. Ultrasound can measure the blood flow in the epididymis, examine the inside of the testis and see other changes in that area of the body. Treatment often starts with a week course of antibiotics. Most cases can be treated out of the hospital with pills. The best medicine for you will depend on the type of bacteria found. The most common antibiotics used are:.
For bad cases of infection, you may need to stay in the hospital for treatment. These are cases with pain that's hard to control with vomiting, high fever and if you are not getting better with antibiotics given by mouth. Occasionally, for bad cases, narcotics are needed for a few days. Tuberculosis epididymitis is more serious but is very rare. It is treated with anti-tuberculous drugs. If damage is bad, surgery may be needed to take out the testis and the epididymis "orchiectomy".
Epididymitis caused by amidarone is treated by limiting or stopping the drug. Your health care provider will tell you what to do. Epididymitis care involves rest for 1 — 2 days with the scrotum raised if possible. The aim is to get the inflamed area above the level of the heart. This helps blood flow, which lowers swelling and pain, and helps with healing. Putting ice on the scrotum now and then can also help. In cases due to infection, it helps to drink fluids.
Anti-inflammatory pills like ibuprofen or naproxen help ease pain. They also ease the swelling that causes the pain. If the pain is severe, a short-term narcotic pain medicine may help but is only used for a short period of time at best in most situations. When this tube becomes swollen, it can cause pain and swelling in the testicles. The condition usually improves with antibiotics. Acute epididymitis lasts six weeks or less. In most cases of acute epididymitis, the testes are also inflamed.
This condition is called epididymo-orchitis. It can be difficult to tell whether the testes, epididymis, or both are inflamed. According to the Centers for Disease Control and Prevention CDC , gonorrhea and chlamydia are the most common causes in men 35 years old or younger. Chronic epididymitis, on the other hand, lasts six weeks or more. Symptoms include discomfort or pain in the scrotum, epididymis, or the testicles. This may be caused by granulomatous reactions, which can result in cysts or calcifications.
Epididymitis may begin with only a few mild symptoms. The most common cause of epididymitis is an STI, specifically gonorrhea and chlamydia. However, epididymitis can also be caused by a nonsexually transmitted infection, such as a urinary tract infection UTI or prostate infection. Read more: What causes groin pain? STIs are a common cause of epididymitis. Gonorrhea and chlamydia are the most common. These infections will cause an infection in the urethra.
Urine and blood tests. Samples of your urine and blood are analyzed for abnormalities. This imaging test might be used to rule out testicular torsion. Ultrasound with color Doppler can determine if the blood flow to your testicles is lower than normal — indicating torsion — or higher than normal, which helps confirm the diagnosis of epididymitis. More Information Ultrasound Urinalysis. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Epididymitis. Centers for Disease Control and Infection.
Accessed Aug. Sometimes the cause of chronic epididymitis isn't identified. 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. The male reproductive system makes, stores and moves sperm. Testicles produce sperm. Fluid from the seminal vesicles and prostate gland combine with sperm to make semen. The penis ejaculates semen during sexual intercourse.
Certain sexual behaviors that can lead to STIs put you at risk of sexually transmitted epididymitis, including having:.
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