Inflammation of the testicles and epididymis (paratesticles)

Overview

The testicles and paratesticles (epididymis) often become diseased at the same time. Inflammation of the epididymis (epididymitis) usually occurs first and then spreads to the testicles (orchitis). Both diseases are characterised by dull and agonising pain in the testicles, which can be slightly alleviated by immobilisation and cooling.

Symptoms

Main symptoms

• Dull pain
• Swollen testicles
• Red and overheated scrotal skin
• Pain radiates into the groin, lower abdomen or back
• General feeling of being unwell, accompanied by fever
• For epididymitis: pain when urinating, urethral discharge

Complications

• Irreversible damage to the testicles or epididymis
• Impediment to fertility
• The testicles can shrink and lose their function
• Testicular or epididymal abscess (collection of pus)

If therapy is unsuccessful, epididymitis can become chronic.

Causes and treatment

Causes

Inflammation of the testicles (orchitis)

• Mostly caused by viruses
• Less often, caused by bacteria (gonorrhoea and syphilis)
• Young men who get mumps can contract orchitis
• Affects the man’s fertility
• Blow to scrotum

Inflammation of the paratesticles (epididymitis)

• Mostly caused by bacteria (urinary tract infections, sexually transmitted infections)
• Blow to scrotum

Further treatment by your doctor / in hospital

Possible tests

• Urine test (search for signs of infection)
• Blood test (inflammatory markers)
• Ultrasound of the testicles (sonography)

Possible therapies

• Painkillers and anti-inflammatory medication
• Antibiotics (for bacteria)
• Immobilisation in a suspensory jockstrap (special underwear to protect the penis and testicles)
• In the worst case, operation to remove the testicles/epididymis

What can I do myself?

• For pain relief:
  • Lie down with a soft cloth folded under the scrotum
  • Cooling compresses
  • Immobilisation
• Vaccination against mumps (MMR vaccine, included in the Swiss vaccination schedule)
• Safer sex rules to prevent sexually transmitted infections
  • Always use a condom or femidom during sexual intercourse
  • Don't get sperm or blood (including menstrual blood) in your mouth, and don’t swallow

When to see a doctor?

• Persistent pain in the scrotal region
• Pain when urinating
• Genital itching or burning

Synonyms

orchitis, epididymitis, abscess, gonorrhoea, syphilis, sexually transmitted infections, sexually transmitted diseases, urinary tract infection, fever