Inflammation of the epididymis can cause pain and swelling in your scrotum. The epididymis is a small tube next to the testicle that stores sperm. Epididymitis is often caused by an infection. In sexually active men, it is often caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhea. In boys and in men 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 one side is affected. The testicle and scrotum swell and become very painful and red. You may have fever and a burning when passing urine. Sometimes you may have a 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 several 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 tips to help you care for yourself at home:

  • Support the scrotum. 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 GI (gastrointestinal) bleeding.

  • Get some rest. Rest in bed for the first few days until the fever, pain, and swelling get better. It may take several 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.

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

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

Follow-up care

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

When to seek medical advice

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

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your provider

  • More pain or swelling of the testicle after starting treatment

  • Pressure or pain in your bladder that gets worse

  • Unable to pass urine for 8 hours

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