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Epididymo-orchitis

What is epididymo-orchitis?

Epidiymo-orchitis is a condition that affects men and is characterised by pain and swelling inside the scrotum (ball bag).

It is due to an infection either in the:

  • epididymis – tube carrying the sperm from the testicle to the urethra (the tube through which you pass urine)
  • testicle
  • epididymis and testicle

An infection of the epididymis is called epididymitis. An infection of the testicle is called orchitis. An infection of both the epididymis and the testicle is called epididymo-orchitis.

An immediate examination is needed to make sure you don’t have a twisted testicle (testicular torsion) as this can result in long-term damage to the testicle if not dealt with quickly.

Epidiymo-orchitis is easily treated with antibiotics, painkillers and rest, but the pain can take weeks to months to completely go away.

How common is epididymo-orchitis?

Epididymo-orchitis occurs most commonly in men aged 19 to 40.

How do I get epididymo-orchitis?

In most men under the age of 35, epididymo-orchitis is caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

In most men over the age of 35, epididymo-orchitis is caused by the same bacteria that cause urinary tract infections.

This may also occur after surgical procedures such as cystoscopy or catheterisation.

Occasionally it may be caused by a ‘gut’ bacterial infection from insertive anal intercourse.

Rarely, it may be caused by other infections such as mumps or tuberculosis.

What symptoms would I have with epididymo-orchitis?

Pain and swelling in one or sometimes both of your testicles that comes on suddenly.

Sometimes you may notice a discharge from the tip of the penis and/or pain on passing urine.

Occasionally you may feel generally unwell with a fever.

How can I be tested for epididymo-orchitis?

Epididymo-orchitis is diagnosed based on your symptoms and what the doctor or nurse finds when they examine you.

If there is any concern that you may have a twisted testicle (testicular torsion), you will be referred for further tests and examination.

If you have epididymo-orchitis, you will likely be asked to give a urine sample and recommended to have a sexual health screen (this tests for routine sexually transmitted infections including chlamydia, gonorrhoea, syphilis and HIV). This will help to find out what may have caused your infection.

How is epididymo-orchitis treated?

Epididymo-orchitis is treated with antibiotics to cover the most likely infections. This may include an injection as well as tablet treatment.

You will be advised to rest, wear a scrotal (ball bag) support and take regular painkillers (for example ibuprofen or paracetamol).

If your symptoms get worse or do not improve within 3 days, you should go back to your doctor or nurse, or seek further medical advice.

Testicular pain and swelling often takes many weeks or months to fully settle after treatment.

What about my partner?

If you have been diagnosed with an STI, it is important that all of the people you have recently been in sexual contact with are given the option to be tested and treated. Your doctor or nurse will discuss this with you.

When can I have sex again?

You will have to wait until you have finished the antibiotics and have had a check-up by your doctor before having sex again, even sex with a condom or oral sex.

If you were diagnosed with an STI, it is really important that you don’t have sex with your partner before they are tested and treated as you could become infected again.

What happens if my epididymo-orchitis is left untreated?

If you do not get treatment, the testicular pain and swelling will last much longer.

An untreated infection is more likely to lead to complications such as long-term testicular pain or an abscess. In rare cases, untreated infection can lead to shrinkage of the testicle and loss of fertility.

Download the Epididymo-orchitis leaflet here.