Epididymitis

What is epididymitis?

Epididymitis happens when a small tube behind your testicles becomes swollen and sore. This tube is called the epididymis. It's usually caused by an infection and can be treated with antibiotics.

What are the symptoms?

You might notice:

• Pain in one or both testicles - this can come on suddenly or slowly get worse
• Your scrotum feels tender, warm and swollen - the scrotum is the bag of skin that holds your testicles
• A lump or swelling - this happens when fluid builds up around your testicle
• Problems when you pee - depending on what's causing it
• Discharge from your penis - this might be white, yellow or green

What causes epididymitis?

The most common causes are:

In men under 35: Usually a sexually transmitted infection (STI) like chlamydia or gonorrhoea.

In men over 35: Usually a urine infection.

Other causes can include:

• A urinary tract infection (more likely if you have an enlarged prostate, use a catheter, or recently had surgery)
• Mumps
• TB (tuberculosis)
• Some heart medicines
• An injury to your groin
• A rare condition called Behçet's disease

When should you see a GP?

See your GP if you have:

• A lump in your testicles
• Swollen testicles
• A change in the shape of your testicles
• A change in how your testicles feel
• One testicle becomes bigger than the other
• Aching or discomfort in your testicles that won't go away

Important: Lumps in testicles can sometimes be a sign of testicular cancer. This is much easier to treat when found early, so don't delay getting checked.

🚨 When to get emergency help

Call 999 or go to A&E immediately if:

• You get sudden, unbearable pain in your testicles or tummy

This could mean your testicle has become twisted, which needs urgent treatment in hospital. Don't drive yourself - ask someone to drive you or call an ambulance.

What happens at your appointment?

Your GP or sexual health clinic might do:

• An examination of your groin area
• A swab test from your penis
• Urine and blood tests
• An examination of your back passage to check your prostate

How is it treated?

The main treatment is antibiotics. These might be given as injections, tablets, or both. It's really important to finish the whole course, even if you start feeling better.

You should feel better within a few days, but it can take up to 3 months to fully recover.

What you can do to help yourself

Do:

• Take painkillers like paracetamol or ibuprofen for pain (speak to a pharmacist if you're taking antibiotics, as some don't mix well with certain painkillers)
• Use a cold pack or bag of frozen peas wrapped in a tea towel on your groin
• Wear supportive underwear

Don't:

• Have sex if you have gonorrhoea or chlamydia until you've finished treatment and waited 7 days after

Getting help

You can get treatment at your GP surgery or at a sexual health clinic. Many sexual health clinics offer walk-in appointments.

If your epididymitis is caused by an STI, your recent sexual partners (from the past 6 months) may also need testing.

Remember, speak to your GP if you have any concerns about symptoms in your testicles.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.