Epididymo-orchitis

Infection of the testis and epididymis (the coiled tube that stores and transports sperm away from the testis) can lead to inflammation called epididymo-orchitis. This condition usually causes painful swelling of one testis and may be accompanied by fever.

What are the causes?

Epididymo-orchitis is usually caused by bacteria that have traveled from the urinary tract along the spermatic duct (vas deferens) to the epididymis. In men under 35 years of age, a common cause of the condition is a sexually transmitted infection (STI), such as nongonococcal urethritis. In older men, a urinary tract infection, prostatitis, or recently having had a catheter inserted to drain urine are possible causes. In rare cases, an infection that is transmitted through the bloodstream, such as tuberculosis, leads to the development of epididymo-orchitis.


In boys and young men, the most common cause of the condition used to be inflammation due to mumps, but this has become less common since the introduction of immunization.

What are the symptoms?

The symptoms of epididymo-orchitis usually develop over a period of several hours and may include:
- Swelling, redness, and tenderness of the scrotum on the affected side.
- In severe cases, extreme pain in the scrotum, with fever and chills.

You may also have some symptoms of the underlying disorder, such as painful and frequent passage of urine in the case of a urinary tract infection.

The symptoms of epididymo-orchitis are similar to those of a more serious condition called torsion of the testis (right). For this reason, you should consult your doctor immediately if you have any of the symptoms listed above.

What may be done?

Your doctor will ask you to provide a urine sample to be tested for infection. If the doctor suspects an STI, he or she will take a swab from your urethra (the tube from the bladder to the outside of the body) to check for infection. If the diagnosis is unclear, you will need to go to hospital as an emergency for tests to rule out torsion of the testis. In some cases, exploratory surgery is necessary.

Your doctor will probably prescribe antibiotics unless the inflammation is caused by infection with the mumps virus, in which case antibiotics are ineffective. You may be advised to rest in bed and drink plenty of fluids. Taking painkillers may help to ease the discomfort, and using an ice pack may reduce the swelling and pain in the scrotum. An athletic support can be worn to support the scrotum.

Pain is usually relieved in 1-2 days, but the swelling of the scrotum may take several weeks to subside.