Epididymitis is an infection that causes inflammation of the epididymis — this is a series of small tubes attached to the back of testicles that collects and stores sperm. 


Epididymitis is usually caused by a bacterial or a sexually transmitted infection but causes vary depending on age and behavior. In children, it is most commonly associated with urinary tract infections (UTIs). In young, sexually active men, it is often linked to sexually transmitted infections (STI), such as chlamydia and gonorrhoea, while in older men it is typically caused by an enlarged prostate gland.

Risk factors include:

  • Unprotected sex
  • Tuberculosis 
  • Use of the heart medication, amiodarone
  • Structural problems in the urinary tract
  • Urinary tract surgery
  • Enlarged prostate causing blockage in the bladder
  • Being uncircumcised
  • Heavy lifting or straining
  • An injury

What are its symptoms?

While epididymitis begins with only a few symptoms, if left untreated it will lead to complications.

Symptoms include:

  • Fever
  • Chills
  • Heavy feeling in testicle
  • Sensitive testicle
  • Enlarged testicle
  • Pain in the abdomen or pelvis
  • Groin pain
  • Frequent need to urinate
  • Burning feeling when urinating
  • Discharge from the penis
  • Yellow sperm
  • Blood in the urine
  • Pain during ejaculation

Complications of acute epididymitis include:

  • Chronic epididymitis
  • Abscess (pocket of pus)
  • Destruction of the epididymis, leading to infertility
  • Spread of infection

How is it diagnosed? 

An epididymitis diagnosis typically starts with your doctor conducting a physical examination and asking you about your symptoms. He/she will look for testicular swelling, swelling of lymph nodes in the groin area, and penile discharge. 

Your doctor will use a swab to collect a sample of the discharge and test for STIs.

If your doctor suspects epididymitis caused by an enlarged prostate, he or she will conduct a rectal examination. He or she may also order blood tests. A complete blood count (CBC) will tell your doctor if there is an infection in your system.

Other diagnostic tests include:

  • Urinalysis (urine test): this may indicate urinary tract infections and STIs.
  • Imaging tests: this can eliminate other conditions, such as testicular torsion (a twisted spermatic cord). Your doctor may use an ultrasound, which uses sound waves to create an image of the structures in the body. 
  • If you undergo a testicular scan, you will need to drink a radioactive substance. Your body will then be scanned by cameras that detect this substance. This reveals information about the blood flow in your testicles, which can help diagnose testicular torsion or epididymitis.

What are your treatment options? 

Treatment involves treating the underlying infection, as well as easing symptoms. Common treatments include:

  • Antibiotics
  • Elevating the scrotum
  • Wearing an athletic cup 
  • Pain and anti-inflammatory medication
  • Bed rest
  • Cold therapy (applying cold packs to the scrotum)
  • Abstaining from sex

These treatments are usually effective but in come cases more invasive treatments are needed.

If an abscess (pocket of pus) has formed, your doctor can drain the abscess using a needle.

Surgery is an option if no other treatments have been successful. This involves removing all or part of the epididymis. This may be an option to correct any physical defects that may be causing the epididymitis.

Can it be prevented? 

In younger men, epididmytis is usually a sexually-related disease. If one partner is infected, the other partner needs be checked and potentially treated as well. 

Prevention methods include: 

  • Abstinence 
  • Consistent use of condoms 
  • Monogamy with an uninfected partner
  • A mumps vaccination
  • People who develop epididymitis after taking amiodarone medication will most likely need to be prescribed a different medication. Consult with your doctor or specialist.
  • For uncircumcised men over 39, good hygiene is suggested; this helps prevent urethral and bladder infections.

How Clicks Clinics can help you

Unprotected sex increases your risk of HIV/AIDS. Clicks offers HIV testing and counselling at our clinics, simply call 0860 254 257 or book with Clicks Clinics online to make an appointment.

Shop for condoms on Clicks.co.za

Don't be caught unawares – rather stock up on condoms so that you can ensure you're practising safe sex at all times. If you'd prefer the convenience of shopping for them online, click here.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2016