Epididymitis

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Blood in semen

Male reproductive anatomy

Male reproductive system

Pathway of sperm

Epididymitis may begin with a low-grade fever, chills, and a heavy sensation in the testicle area. The area becomes more and more sensitive to pressure.

Other symptoms include:

• Blood in the semen
• Discharge from the urethra (the opening at the end of the penis)
• Discomfort in the lower abdomen or pelvis
• Fever
• Groin pain
• Lump in the testicle
• Pain during ejaculation
• Pain or burning during urination
• Painful scrotal swelling (epididymis is enlarged)
• Tender, swollen groin area on affected side
• Testicle pain that gets worse during a bowel movement

Physical examination shows a red, tender, and sometimes swollen lump (mass) on the affected side of the scrotum. Tenderness is usually in a small area of the testicle where the epididymis is attached.

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There may be enlarged lymph nodes in the groin area (inguinal nodes), and a discharge from the penis. A rectal examination may show an enlarged or tender prostate.

These tests may be performed:

• Complete blood count (CBC)
• Doppler ultrasound
• Testicular scan (nuclear medicine scan)
• Urinalysis and culture (you may need to give several specimens, including initial stream, mid-stream, and after a prostate massage)
• Tests for chlamydia and gonorrhea

It is important to distinguish this condition from testicular torsion. Testicular torsion is an emergency and should be treated with surgery as soon as possible.

Review Date: 08/13/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).