Epididymitis means inflammation of the epididymis (the structure next to the testis that is involved in making sperm). Orchitis means inflammation of a testis (testicle).

What causes epididymo-orchitis?

The common causes are:

  • A complication from a urine infection
  • Sexually transmitted infection
  • The mumps virus
  • An operation to the prostate or urethra
  • Medication
  • Epididymo-orchitis can occasionally be a side-effect of a drug called amiodarone. It normally occurs at doses above 200 mg.
Who gets epididymo-orchitis?

Epididymo-orchitis occurs in about 1 in 1,000 males. It is common in men aged 15-30, and in men aged over 60. Your risk of getting epididymo-orchitis is increased if you have a catheter or other instruments inserted into the urethra.

What are the symptoms of epididymo-orchitis?

Symptoms usually develop quickly - over a day or so. The affected epididymis and testis swell rapidly, and the scrotum becomes enlarged, tender, and red. It can be very painful. There may be pain on passing urine if you have a urine infection; a discharge from the penis if you have a urethral infection; etc. As with any infection, you may have a fever and feel generally unwell.

Are any tests needed?
  • Tests to look for infecting bacteria
  • A urine test will usually be done if a urine infection appears to be the root cause. A swab of the urethra or other tests may be done if a sexually transmitted infection is thought to be the root cause

  • Tests of the urinary tract
  • Tests to look into the urethra and bladder may be needed if a urine infection is the cause, and this is thought to be due to partial blockage of urine flow or other urinary tract abnormalities.
What is the treatment for epididymo-orchitis?

A course of antibiotics is usually advised as soon as epididymo-orchitis is diagnosed. These normally work well. Pain usually eases within a few days, but swelling may take a week or so to go down, sometimes longer. The choice of the antibiotic depends on the underlying cause of the infection.

Supporting underwear helps to ease the pain. Painkillers and ice packs will also ease the pain.

Are there any complications from epididymo-orchitis?
  • An abscess occasionally develops in the scrotum. This may need a small operation to drain the pus.
  • Reduced fertility in the affected testis.
  • Rarely, serious damage to the testis may occur and result in gangrene (dead tissue) in the testis that needs to be surgically removed.

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