Epididymitis is inflammation of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. It often causes scrotal pain, swelling, tenderness, and warmth on one side. ^[1][3][4]

In younger sexually active men, sexually transmitted infections can be an important cause. In older men, urinary tract pathogens and structural urinary problems may play a larger role. ^[1][2][4]

What symptoms can occur?

Symptoms commonly include gradual onset of scrotal pain, swelling, redness, tenderness, pain with urination, urinary frequency, fever, and discomfort during ejaculation in some cases. ^[1][3][5]

Because acute scrotal pain has several possible causes, diagnosis should not be based on symptoms alone. Testicular torsion, for example, is an emergency that must be ruled out quickly. ^[1][2]

What causes epididymitis?

Bacterial infection is a frequent cause. Sexually transmitted pathogens such as chlamydia and gonorrhea are important in some age groups, while enteric bacteria may be involved in others. Noninfectious inflammation can also occur less commonly. ^[1][4]

Risk factors may include recent urinary procedures, unprotected sex, urinary obstruction, prostate enlargement, or a history of urinary infection. ^[2][5]

How is it diagnosed?

Diagnosis usually involves medical history, genital examination, urine testing, and sometimes STI testing. Scrotal ultrasound may be used when torsion or another condition must be excluded. ^[1][2][4]

The practical goal is to confirm inflammation, identify the likely cause, and make sure a more urgent diagnosis is not being missed. ^[1][3]

How is it treated?

Treatment depends on the cause. Antibiotics are used when infection is suspected or confirmed. Supportive measures such as rest, scrotal support, and pain relief are also important. ^[1][2][4]

Prompt treatment matters because untreated epididymitis can lead to abscess formation, chronic pain, or fertility-related complications in some cases. ^[1][3]

When is urgent care needed?

Sudden severe testicular pain, nausea, vomiting, or a high-riding testicle requires immediate evaluation because torsion may be present. Fever, marked swelling, or worsening symptoms despite treatment also need prompt reassessment. ^[1][2]

Men with scrotal pain should not delay care out of embarrassment. The differential diagnosis includes urgent conditions. ^[1][5]

FAQ

Is epididymitis always caused by an STI?

No. STIs are one cause, but urinary bacteria and other factors can also be involved. ^[1][4]

Can epididymitis cause swelling?

Yes. Pain, swelling, tenderness, and warmth are common features. ^[1][3]

Why is torsion important to rule out?

Because testicular torsion is a surgical emergency that can also cause acute scrotal pain. ^[1][2]

Is ultrasound always needed?

Not always, but it is often used when the diagnosis is uncertain or torsion must be excluded. ^[1][2]

When should I seek urgent care?

You should seek urgent care for sudden severe pain, fever, rapid swelling, or worsening symptoms. ^[1][2]