What is epididymitis?

Epididymitis is a painful condition usually caused by infection or inflammation of the epididymis, a curved, tube-shaped structure connected to the testicle.

Causes

Epididymitis may be caused by a bacterial infection occurring along the urinary tract. In children, epididymitis can also develop due to inflammation from direct trauma, twisting of a portion of the epididymis (torsion), or backward flow (reflux) of urine into the epididymis. Symptoms The onset of epididymitis is typically gradual with testicle pain that increases in severity over time. The testicle may become swollen, tender to touch and/or red.

Other symptoms can include:

• Pain or burning with urination
• Red and tender area on the side of the scrotum (the sac of skin that contains the testicles)
• Discomfort in the lower abdomen or pelvis
• Fever

Testing and diagnosis

During the physical exam, redness, tenderness and sometimes a swollen lump may be found on the affected side of the scrotum. If epididymitis is suspected, the following tests may be completed to confirm the diagnosis:

• Urinalysis (chemical analysis of urine) and urine culture (checks for bacteria in urine)
• Scrotal ultrasound (painless test that takes pictures of scrotal area)
• Uroflow and bladder scan (tests that measure urine flow rate and how long it takes to empty bladder)

Treatment

In most cases, epididymitis will resolve on its own with time. Rest and ibuprofen can help decrease inflammation and pain. Supportive underwear can also help. Sometimes antibiotics are necessary if the epididymitis is caused by a bacterial infection. Your child’s pediatric urology provider will recommend the most appropriate treatment for your child.

Bathroom habits can contribute to epididymitis. Infrequent urination and/or straining with urination may play a role and we typically ask that an individual empty their bladder on a routine schedule, increases the amount of water they drink and monitors bowel movements for any signs of constipation.

* It is important to note that if your child is having sudden scrotal pain, they should be taken to the emergency room for an evaluation immediately.