Epididymitis and Testicular Pain


At the back of each testicle is a coiled tube called the epididymis that stores and carries sperm.

When this tube become inflamed (painful, warm and swollen), it’s known as epididymitis.

The cause of epididymitis is usually an infection, and antibiotics may be needed. It might take several weeks for the symptoms to get better.

If the testicles are also inflamed, it’s known as epididymo-orchitis.

Symptoms of Epididymitis

Epididymitis causes sudden pain in one or both of the testicles.

The scrotum will feel tender, warm and swollen.

There may be a build-up of fluid around the testicle (a hydrocele), which will feel like a lump or a swelling

Sometimes there may also be a discharge from the tip of the penis.

This means the cause may be a sexually transmitted disease (STD)

If it becomes difficult to pee, or you need to pee more often.

This means the cause may be a urinary tract infection.

If you think you have these symptoms you should see your doctor , so the cause can be properly examined for further investigation.


What are the Causes of Epididymitis

Epididymitis is usually caused by:

  • Sexually transmitted disease such as chlamydia and gonorrhoea
  • Urinary Tract Infection (UTI)

UTIs are much less common in men than women.

In men, a UTI may be caused by an enlarged prostate gland pressing on the bladder, or recent surgery to the groin, prostate gland or bladder.

Men of any age can develop epididymitis.

More unusually, epididymitis is caused by:

  • Mumps
  • Tuberculosis
  • urine flowing back into the epididymis after heavy lifting or straining, or associated with an enlarged prostate gland
  • a groin injury

When the cause isn’t known, it’s termed idiopathic epididymitis.


We will probably need to carry out a physical examination of your groin, to check for signs of inflammation and infection.

To find out the underlying cause of the epididymitis, you may need to have: 

  • a test for gonorrhea and chlamydia, where a narrow swab is inserted into your penis to collect a sample of discharge
  • urine and blood tests
  • if there is any suspicion that you have an underlying testicular lump, an ultrasound scan of the scrotum may be recommended

Treatment for Epididymitis

1.) Rest and painkillers

If you’ve been diagnosed with epididymitis, you’ll need to rest and painkillers to manage any pain.

It may help to: lie in bed with your scrotum raised, wear a scrotal support, or hold a cold pack to your groin

2.) Antibiotics

If the underlying cause is an infection, you may need treatment of urinary tract infection .

If you have gonorrhoea or chlamydia, you’ll need to avoid having sex until you and your partner have completed treatment for this.

Frequently Asked Questions (FAQs):

What about my partner?

If you have been diagnosed with an STD then all recent partners need to have a full sexual health screen and antibiotic treatment. Your clinic will advise you further about this.


When can I have sex again?

You must not have sex again until both you and your partners have each completed treatment and follow up by your doctor


What happens if my epididymo-orchitis is left untreated?

The testicular pain and swelling will last much longer.

Untreated infection is more likely to lead to complications such as:

  • Epididymo-orchitis (inflammed testicles )
  • Long term testicular pain
  • Loss of fertility