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Epididymitis is inflammation of the epididymis – the coiled tube attached to the back and upper side of the testicle that stores sperm and passes it to the vas deferens (the duct that transports sperm from the epididymis to the ejaculatory ducts and the urethra).

Orchitis is inflammation of the testicle, typically with a sudden onset. When both the epididymis and testicle get inflamed, the condition is called epididymo-orchitis.

Symptoms of Epididymitis

Epididymitis can be either acute or chronic. Acute epididymitis comes on quickly with severe symptoms that resolve with treatment, including:

  • Pain, swelling, redness, or soreness of the scrotal sac
  • Warmth and firmness of the scrotal skin
  • Fever, urethral discharge, urinary frequency and/or urgency, painful/burning urination

Chronic epididymitis tends to develop more slowly and over longer periods of time, for which the symptoms may improve with treatment but may not completely disappear. Symptoms of chronic epididymitis include pain or discomfort in the scrotum only. It is less severe and more localized than acute epididymitis. Pain, swelling, redness, or soreness of the scrotal sac do not occur.

Risk Factors for Epididymitis

There is not always a known cause for epididymitis, but risk factors include:

  • Being a sexually active man, typically under the age of 40 years, with exposure to sexually transmitted diseases that cause infection of the epididymis, such as gonorrhea or chlamydia
  • Men who have had urinary tract infections; more common in men over 40
  • Trauma/injury to the scrotal sac or testicles
  • Having had mumps
  • Having or having had prostatitis

Diagnosing Epididymitis

Your doctor will perform a thorough history and physical exam. Tests may include:

  • Urinalysis to check for infection
  • A swab of the urethra (a tube that carries urine from the bladder to the outside of the body) to check for a sexually transmitted infection
  • Ultrasound of the scrotum to make sure the testicles are not twisted or do not have tumors

Treatment for Epididymitis

Treatment will depend on the cause. Warm soaks and/or icepacks and scrotal support may be used to treat epididymitis and orchitis. Antibiotics or anti-inflammatory medications may be prescribed.

Complete resolution of symptoms may take some time, but you should notice improvement within a few days after starting treatment. Pain or discomfort may subside after the full course of antibiotics is complete, but the firmness and swelling may take months to resolve.

Miami urologist Dr. Marvin Bondhus sees and treats men with epididymitis from throughout Miami-Dade County. For a consultation, call (305) 661-9692 or use our secure online appointment request form.