The epididymis is a delicate organ located at the back of each testicle and is necessary for the storage of sperm. Epididymitis is an acute onset, painful swelling of the epididymis, which may be accompanied by fever and painful urination. The usual treatment is antibiotics. If the patient has trouble emptying their bladder, it may become necessary to temporarily drain the urine through a catheter.

Questions about the diagnosis and treatment of epididymitis

The two epididymis lie on the side of the testicles and serve to mature and store the sperm. The epididymis are directly connected to the urinary tract via the vas deferens, where they end near the prostate. Bacteria can rise through this pathway and cause epididymitis (inflammation of the epididymis). There are also other infection routes, but they are less important.

The most common cause is a bladder emptying disorder. This is usually due to benign enlargement of the prostate, which causes difficult or incomplete urination. In this environment, bacteria can colonise more easily and cause inflammation of the urinary organs. This is why the causes are similar to that of prostatitis. In fact, both diseases often occur simultaneously.

Young men can also be affected by epididymitis, but this is mainly caused by sexually transmitted diseases such as chlamydia.

The actual epididymitis is often preceded by symptoms of cystitis, such as painful and frequent urination. In addition, the epididymis severely and painfully swells, and the scrotum reddens. An additional symptom in most cases includes fever.

If epididymitis is not treated or is left untreated for a long enough period of time, it can develop into a chronic condition that causes permanent pain. Encapsulations (abscesses) can form, and blood poisoning may also occur.

As with any urinary tract infection, enough fluid intake is important. Local cooling and elevation of the scrotum are also helpful. If the patient is incompletely emptying their bladder or has a fever, a bladder catheter should be placed.

In severe or chronic cases, it may sometimes be necessary to remove the entire epididymis through a small incision in the scrotum.

Epididymitis should be treated with antibiotics. In case of fever, the antibiotics are administered intravenously, making an inpatient stay necessary. Decongestant medicines relive the symptoms.

With proper antibiotic treatment, the acute symptoms usually subside significantly within a few days. However, swelling and hardening of the epididymis usually last much longer and can take several weeks to go away. The inflammation can also cause permanent water retention in the area of the testicle or epididymis.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020