Inflammation of the epididymis can cause pain and swelling in your scrotum. The epididymis is a small tube next to each testicle that stores sperm. Epididymitis is often caused by an infection. In sexually active adults, it's often caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhea. In children and in adults over 40, it can be from bacteria from other parts of the urinary tract (not an STI infection).

Symptoms may begin with pain in the lower belly (abdomen) or low back. The pain then spreads down into the scrotum. Often only 1 side is affected. The testicle and scrotum swell and become very painful and red. You may have a fever and a burning feeling when passing urine. Sometimes you may have discharge from the penis.

Treatment is with antibiotics, and anti-inflammatory and pain medicines. The condition should get better over the first few days of treatment. But it will take a few weeks for all the swelling and mild pain to go away. If your healthcare provider thinks that an STI is the cause, your sexual partners may need to be treated.

Home care

Here are some home care tips to help you or your child:

  • Support the scrotum. For older children and adults: When lying down, place a rolled towel under the scrotum. When walking, use an athletic supporter or 2 pairs of jockey-style underwear.

  • To ease pain, put ice packs on the inflamed area. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel. Never put an ice pack directly on the skin.

  • Take pain medicine as directed. You may use over-the-counter medicines to control pain, unless another medicine was given. If you have long-term (chronic) liver or kidney disease, talk with your healthcare provider before taking these medicines. Also talk with your provider if you've ever had a stomach ulcer or digestive tract bleeding.

  • Get some rest. Rest in bed for the first few days until the fever, pain, and swelling get better. It may take a few weeks for all of the swelling to go away.

  • Prevent constipation. Constipation can make you strain. This makes the pain worse. Prevent constipation by eating natural laxatives. These include prunes, fresh fruits, and whole-grain cereals. If needed, use a mild over-the-counter laxative for constipation. Mineral oil can be used to keep the stools soft.

  • Take all medicine as directed. Don't miss any doses. And don't stop taking your medicine early, even if you feel better.

  • Teens and adults: Wait to have sex. Don't have sex until you've finished all treatment and all symptoms have cleared.

Follow-up care

Follow up with your healthcare provider, or as advised, to be sure you're responding correctly to treatment. If a culture was taken, you may call for the result as directed. A culture test can ensure that you're on the correct antibiotic. 

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4ºF (38ºC) or higher, or as advised by your child's or your healthcare provider

  • More pain or swelling of the testicle after starting treatment

  • Pressure or pain that gets worse

  • Unable to pass urine for 8 hours

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