What is Epididymo-orchitis?

Epididymo-orchitis is the inflammation of the epididymis, which is a tube located at the back of the testicles (balls) that stores and carries sperm to the tip of the penis; or the orchitis, which are the testicles themselves. For this reason, epididymo-orchitis only affects men.

If an infection is present, either the epididymis or the orchitis can become extremely painful and/or swollen. Left untreated, epididymo-orchitis can cause serious health problems, such as infertility, or ongoing problems with swelling in the epididymis, testicle(s), or scrotum.

What are the symptoms?

It is really important that you seek medical attention as soon as the pain occurs as symptoms can quickly develop over a day or so. Common symptoms of epididymo-orchitis include:

  • A rapid onset of pain and swelling in one, or sometimes both, of your testicles
  • Discharge from the tip of the penis
  • Pain when peeing
  • Feeling unwell with a fever

In some cases the symptoms listed may be caused by a twisted testicle known as testicular torsion. Testicular torsion is a medical emergency and you must make sure that you’re seen by a doctor as soon as possible, as this can result in long-term damage if not treated quickly.

How do you catch it?

Epididymo-orchitis is usually caused by nonsexual, or sexually transmitted infections, such as gonorrhoea and chlamydia, which can be caught through unprotected sexual contact. It occurs most frequently in men aged 19-40.

For men over 35 years, a urine infection is a common cause, but it may also occur after surgical procedures such as a cystoscopy (a medical procedure to examine the bladder) or catheterisation (a process used to drain the bladder through a tube called a catheter). Occasionally, epididymo-orchitis may be caused by a gut bacterial infection caused by insertive anal intercourse, and very occasionally by other infections, such as mumps or tuberculosis.

Preventing it

If you are sexually active, the best way to prevent epididymo-orchitis is to use condoms for oral, vaginal, and anal sex. If you, or your partner(s) have STI symptoms, or have been exposed to an STI, make sure you get tested and stop sexual contact until know you have been treated or have the all clear.

Getting tested

You cannot test for epididymo-orchitis, but our clinicians can examine you and decide based on your symptoms and response to treatment.

If you are suspected of having epididymo-orchitis, it is important that you have a full STI screen to try and identify what has caused these symptoms.


Epididymo-orchitis can be treated with antibiotics. You may be given a course of Doxycycline to take for up to two weeks. But, if gonorrhoea is suspected as the potential cause, then you may also be given an injection. Antibiotics are generally safe to use unless you’re allergic to them. If you are allergic, alternative options will be prescribed. If your symptoms do not improve after three days of treatment you should go back to the clinic for a review.

As well as this, you will be advised to rest, wear a scrotal support and take regular over-the-counter painkillers such as Ibuprofen or Paracetamol to manage your pain.

It is essential that you don’t have sex or any sexual contact until after your treatment is complete and you have been re-examined by a doctor or a nurse. If it suspected that you have epididymo-orchitis, it is important that you tell all of the sexual partners you have had within the last six months, so that they can also get tested and treated; even if all of your results come back as negative. We can help you get in contact with these people anonymously and provide local support.

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