Epididymitis

What is epididymitis?

Epididymitis refers to inflammation of the epididymis – a densely coiled tube, in which sperm mature and are transported from the testis to the vas deferens. This can be caused by an infection – bacterial or non-bacterial (viral), trauma or reflux of urine into the epididymis.

Why come to Children's Hospital Colorado for treatment of this condition?

The professionals at Children's Hospital Colorado in Aurora, Colorado are dedicated to caring for kids. The members of the urology team are experts in pediatric urologic conditions and our surgeons are specialized in both pediatrics and urology. We strive to help patients and families feel educated about their condition, prepared for treatment and fully cared for by our urology team. 

What are the signs and symptoms?

Epididymitis usually presents with a gradual onset of scrotal pain that increases in severity over several hours. This is usually associated with swelling of the epididymis, which becomes tender to the touch.   In time, fluid may accumulate around the testis – this is called a hydrocele – and the scrotum may become red and warm to the touch.

When epididymitis is caused by an infection, there are usually problems passing urine – this can include urinary frequency, urgency and pain with urination. It also may be associated with a fever, be blood in the urine or urethral discharge.

How do you diagnose it?

A medical history and physical examination is performed in order to diagnose this condition. A urine specimen will be obtained and sent for a urinalysis – this will help determine whether or not your child has a urinary tract infection.   A scrotal ultrasound may also be performed to help distinguish epididymitis from other conditions that present similar symptoms.

How is it treated?

The primary treatment for epididymitis is rest. Elevation of the scrotum and intermittent application of an ice pack may be of some benefit. Ibuprofen is usually recommended for pain relief and to help reduce inflammation. When epididymitis is caused by a bacterial infection, an antibiotic is also prescribed.

Who gets it, and can it be prevented?

Males of all ages can get epididymitis. In many cases, epididymitis cannot be prevented. However, prompt treatment of a urinary tract infection may prevent spread to the epididymis. Taking appropriate precautions against sexually transmitted diseases will also reduce the risk of developing epididymitis.

When should I seek medical attention?

Not all scrotal pain is due to epididymitis. In some cases, the pain may be the result of twisting of the blood vessels to the testicle which reduces blood flow to the testis – this is called testicular torsion. In most cases, emergent surgical intervention is required to untwist the spermatic cord in an effort to save the testis. Although this condition usually has a sudden-onset and is associated with severe scrotal pain, this is not always the case. With this in mind, we recommend that all scrotal pain be assessed by a healthcare provider in a timely fashion.