Epididymitis

Epididymitis is inflammation of the coiled tube behind the testicle where sperm mature. A bacterial infection is usually responsible. However, sudden pain in one testicle may also be a twisted testicle and needs urgent assessment.

• Symptoms usually include pain and swelling on one side, a warm or red scrotum and sometimes fever, pain when passing urine or penile discharge.
• A sexually transmitted infection may play a part in sexually active young people and adults; at other ages, urinary bacteria are more often responsible.
• Symptoms alone cannot safely distinguish epididymitis from a twisted testicle or another condition.
• Assessment may include physical examination, urine and STI tests and an ultrasound if uncertain. A normal urine result does not rule out a twisted testicle.
• Bacterial epididymitis is treated with antibiotics. Choice and duration depend on the suspected bacterium, STI risk, urinary tract and local resistance.
• Rest, scrotal support and suitable pain relief may reduce symptoms. Swelling may remain noticeable for weeks after successful treatment.
• Complete the antibiotic course and have STI partners assessed and treated when advised.
• Seek help without delay for sudden severe pain, nausea, a high-riding testicle or pain after an accident.