Signs and symptoms of epididymitis might include:
- A swollen, red or warm scrotum
- Testicle pain and tenderness, usually on one side
- Painful urination or an urgent or frequent need to urinate
- Discharge from the penis
- Painful intercourse or ejaculation
- A lump on the testicle
- Enlarged lymph nodes in the groin
- Pain or discomfort in the lower abdomen or pelvic area
- Blood in the semen
- Less commonly, fever
Epididymitis that lasts longer than six weeks or that recurs is considered chronic. Symptoms of chronic epididymitis might come on gradually. Sometimes the cause of chronic epididymitis is not identified.
When to see a doctor
Never ignore scrotal pain or swelling. Scrotal pain can be caused by a number of conditions, and some of them require immediate treatment to avoid permanent damage.
If scrotal pain is severe, seek emergency treatment. Also see a doctor if you have discharge from your penis or pain when you urinate.
Causes of epididymitis include:
- STIs. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.
- Other infections. For boys and men who aren't sexually active, epididymitis can be caused by a nonsexually transmitted bacterial infection. In boys and men with urinary tract or prostate infections, bacteria might spread from the infected site to the epididymis.
- Amiodarone (Pacerone). This heart medication can cause inflammation of the epididymis.
- Urine in the epididymis (chemical epididymitis). This condition occurs when urine flows backward into the epididymis, possibly because of heavy lifting or straining.
- Trauma. A groin injury can cause epididymitis.
- Tuberculosis. Rarely, epididymitis can be caused by tuberculosis infection.
Certain sexual behaviors that can lead to STIs put you at risk of sexually transmitted epididymitis, including having:
- Sex with a partner who has an STI
- Sex without a condom
- A personal history of STI
Risk factors for nonsexually transmitted epididymitis include:
- History of prostate or urinary tract infections
- History of medical procedures that affect the urinary tract, such as insertion of a urinary catheter or scope into the penis
- An uncircumcised penis or an anatomical abnormality of the urinary tract
- Prostate enlargement, which increases the risk of bladder infections and epididymitis
Untreated, epididymitis can become chronic. Other complications include:
- Puss-filled infection (abscess) in the scrotum
- Epididymo-orchitis, if the condition spreads from your epididymis to your testicle
- Rarely, reduced fertility
To help protect against STIs that can cause epididymitis practice safe sex.
If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor might discuss with you other ways to prevent epididymitis from recurring.