Summary: Inflammation of the EPIDIDYMIS. Its clinical features include enlarged epididymis, a swollen SCROTUM; PAIN; PYURIA; and FEVER. It is usually related to infections in the URINARY TRACT, which likely spread to the EPIDIDYMIS through either the VAS DEFERENS or the lymphatics of the SPERMATIC CORD.

Top Publications

  1. von Schnakenburg C, Hinrichs B, Fuchs J, Kardorff R. Post-transplant epididymitis and orchitis following Listeria monocytogenes septicaemia. Pediatr Transplant. 2000;4:156-8 pubmed
    We report the occurrence of epididymitis and orchitis 1 week after the onset of Listeriosis in an 11-month-old boy receiving an orthotopic liver transplantation for biliary atresia...
  2. Haidl G, Allam J, Schuppe H. Chronic epididymitis: impact on semen parameters and therapeutic options. Andrologia. 2008;40:92-6 pubmed publisher
    ..With regard to their impact on male reproductive function, epididymitis seems to be more relevant than inflammation/infection of the prostate and/or seminal vesicles...
  3. Nistal M, Gonzalez Peramato P, Serrano A, Regadera J. Xanthogranulomatous funiculitis and orchiepididymitis: report of 2 cases with immunohistochemical study and literature review. Arch Pathol Lab Med. 2004;128:911-4 pubmed
    ..Differential diagnoses with other lesions that are rich in macrophages, such as malakoplakia, and those testicular neoplasms without serologic tumor markers are discussed...
  4. Furuya R, Takahashi S, Furuya S, Kunishima Y, Takeyama K, Tsukamoto T. Is seminal vesiculitis a discrete disease entity? Clinical and microbiological study of seminal vesiculitis in patients with acute epididymitis. J Urol. 2004;171:1550-3 pubmed
    ..direct evidence of inflammatory involvement of the seminal vesicles has not previously been reported in patients with acute epididymitis. We verified the discrete disease entity of seminal vesiculitis associated with acute epididymitis.
  5. Nickel J, Teichman J, Gregoire M, Clark J, Downey J. Prevalence, diagnosis, characterization, and treatment of prostatitis, interstitial cystitis, and epididymitis in outpatient urological practice: the Canadian PIE Study. Urology. 2005;66:935-40 pubmed
    To determine the prevalence, diagnostic patterns, and management of prostatitis, interstitial cystitis, and epididymitis (PIE) in Canadian urology outpatient practice.
  6. Cho Y, Jung J, Lee K, Bang D, Lee E, Lee S. Clinical features of patients with Behçet's disease and epididymitis. J Urol. 2003;170:1231-3 pubmed
    b>Epididymitis is a rare manifestation of Behçet's disease but its clinical significance is still not fully understood. We evaluated the clinical significance of epididymitis in patients with Behçet's disease.
  7. Kiyan G, Dagli T, Iskit S, Tugtepe H. Epididymitis in infants with anorectal malformation. Eur Urol. 2003;43:576-9 pubmed
    To document the characteristics of epididymitis in boys with anorectal malformations.
  8. Gift T, Owens C. The direct medical cost of epididymitis and orchitis: evidence from a study of insurance claims. Sex Transm Dis. 2006;33:S84-8 pubmed
    b>Epididymitis and orchitis (EO) are the primary sequelae of acute chlamydia and gonorrhea in men. Existing estimates of the cost per episode of epididymitis are over 10 years old or are based on limited data.
  9. Coulier B, Ramboux A, Maldague P. Emphysematous epididymitis as presentation of unusual seminal vesicle fistula secondary to sigmoid diverticulitis: case report. Abdom Imaging. 2005;30:113-6 pubmed
    ..diverticulitis with torpid development, long-term symptoms of bladder irritability, and an emphysematous epididymitis caused by a direct seminal vesicle fistula...

More Information


  1. Díaz Aparicio E, Tenorio Gutiérrez V, Arellano Reynoso B, Enríquez Verdugo I, Aguilar Romero F. Pathogenicity of different strains of Histophilus somni in the experimental induction of ovine epididymitis. Can J Vet Res. 2009;73:157-60 pubmed
    ..with different Histophilus somni isolates: a) 2336 bovine origin strain; b) an isolate from ram orchitis and epididymitis; c) an isolate from the brain of a sheep with neurological signs; d) an isolate from the vagina of a clinically ..
  2. Haecker F, Hauri Hohl A, von Schweinitz D. Acute epididymitis in children: a 4-year retrospective study. Eur J Pediatr Surg. 2005;15:180-6 pubmed
    To evaluate the incidence of acute epididymitis (AE) compared to testicular torsion (TT) as a form of acute scrotum in children, to describe clinical aspects and to assess the value of laboratory tests and radiological investigations in AE...
  3. Viswaroop B, Kekre N, Gopalakrishnan G. Isolated tuberculous epididymitis: a review of forty cases. J Postgrad Med. 2005;51:109-11, discussion 111 pubmed
    Tuberculous epididymitis is one of the causes of chronic epididymal lesions. It is difficult to diagnose in the absence of renal involvement.
  4. Colmenero J, Muñoz Roca N, Bermudez P, Plata A, Villalobos A, Reguera J. Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis. Diagn Microbiol Infect Dis. 2007;57:367-72 pubmed
    ..Pending clinical trials to confirm the results, conservative management with a combination of doxycycline for 2 months and streptomycin for 14 to 21 days appears to be adequate and could avoid unnecessary orchiectomy...
  5. Graumann L, Dietz H, Stehr M. Urinalysis in children with epididymitis. Eur J Pediatr Surg. 2010;20:247-9 pubmed publisher
    The aim of this study was to examine the diagnostic and therapeutic yield of urine tests in epididymitis in children...
  6. Sah S, Bhadani P, Regmi R, Tewari A, Raj G. Fine needle aspiration cytology of tubercular epididymitis and epididymo-orchitis. Acta Cytol. 2006;50:243-9 pubmed
    To study the role of fine needle aspiration cytology (FNAC) and ancillary studies in the diagnosis of tubercular epididymitis or epididymo-orchitis.
  7. Singh I, Dev G, Singh N. Chronic epididymitis (epididymal nodule) mimicking an adenomatoid tumor--case report with review of literature. Int Urol Nephrol. 2002;34:219-22 pubmed
    To describe and review the differential diagnosis of epididymal nodules and chronic epididymitis so as to have a broad view of this pathology. We have suggested a possible diagnostic algorithm for the workup of an epididymal nodule.
  8. Vicari E, Calogero A. Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis. Hum Reprod. 2001;16:2338-42 pubmed
    We have recently shown that patients with prostato-vesiculo-epididymitis (PVE) have a greater reactive oxygen species (ROS) overproduction than patients with prostatitis or prostato-vesiculitis...
  9. Ludwig M, Johannes S, Bergmann M, Failing K, Schiefer H, Weidner W. Experimental Escherichia coli epididymitis in rats: a model to assess the outcome of antibiotic treatment. BJU Int. 2002;90:933-8 pubmed
    To assess the effect of initial antimicrobial therapy with a new highly potent quinolone (sparfloxacin) on the outcome of infection, especially acute and chronic inflammation, in a rat model of unilateral Escherichia coli epididymitis.
  10. Ito S, Tsuchiya T, Yasuda M, Yokoi S, Nakano M, Deguchi T. Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis. Int J Urol. 2012;19:234-8 pubmed publisher
    Acute epididymitis is often associated with urethritis. Mycoplasma genitalium and Ureaplasma urealyticum have been considered as pathogens of urethritis...
  11. Wharton I, Chaudhry A, French M. A case of mumps epididymitis. Lancet. 2006;367:702 pubmed
  12. Tracy C, Costabile R. The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?. World J Urol. 2009;27:259-63 pubmed publisher
    To review the evaluation and treatment of epididymitis in a contemporary population and evaluate adherence to Centers for Disease Control (CDC) guidelines.
  13. Sakellaris G, Charissis G. Acute epididymitis in Greek children: a 3-year retrospective study. Eur J Pediatr. 2008;167:765-9 pubmed
    ..features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes...
  14. Boettcher M, Bergholz R, Krebs T, Wenke K, Treszl A, Aronson D, et al. Differentiation of epididymitis and appendix testis torsion by clinical and ultrasound signs in children. Urology. 2013;82:899-904 pubmed publisher
    To identify the signs that can help to differentiate torsion of the appendix testis (AT) and epididymitis and to establish the incidence of the various pathologic entities in boys with an acute scrotum.
  15. Chen M, Pan Y, Britt H, Donovan B. Trends in clinical encounters for pelvic inflammatory disease and epididymitis in a national sample of Australian general practices. Int J STD AIDS. 2006;17:384-6 pubmed
    Trends in the frequency of clinical encounters for pelvic inflammatory disease (PID) and epididymitis in Australian general practice were determined via a national representative study of general practice activity between 1998 and 2003...
  16. Celen M, Ulug M, Ayaz C, Geyik M, Hosoglu S. Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience. Braz J Infect Dis. 2010;14:109-15 pubmed
    ..the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey...
  17. Alves L, Assis B, Rezende M. Schistosomal epididymitis. Int Braz J Urol. 2004;30:413-5 pubmed
    b>Epididymitis is a frequent inflammatory process. It is related to sexually transmitted diseases, urinary tract infections by E. coli, or scrotal trauma...
  18. Yap R, Jang T, Gupta R, Pins M, Gonzalez C. Xanthogranulomatous orchitis. Urology. 2004;63:176-7 pubmed
    ..Only two prior cases of xanthogranulomatous orchitis have been reported. This case highlights the need for a broad differential diagnosis when approaching testicular masses, particularly in the setting of coincident infection...
  19. Somekh E, Gorenstein A, Serour F. Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol. 2004;171:391-4; discussion 394 pubmed
    We studied the etiology and management of pediatric epididymitis.
  20. Santillanes G, Gausche Hill M, Lewis R. Are antibiotics necessary for pediatric epididymitis?. Pediatr Emerg Care. 2011;27:174-8 pubmed publisher
    To determine the percentage of cases of epididymitis in pediatric patients that is of bacterial cause and to identify factors that predict a positive urine culture.
  21. Qu N, Terayama H, Naito M, Ogawa Y, Hirai S, Kitaoka M, et al. Caput epididymitis but not orchitis was induced by vasectomy in a murine model of experimental autoimmune orchitis. Reproduction. 2008;135:859-66 pubmed publisher
    ..characterized by lymphocytic infiltration into the testes, spermatogenic disturbance, and a complete lack of epididymitis. In this study, we investigated the effects of vasectomy (Vx) on TGC-induced EAO expecting that Vx augments the ..
  22. Al Taheini K, Pike J, Leonard M. Acute epididymitis in children: the role of radiologic studies. Urology. 2008;71:826-9; discussion 829 pubmed publisher
    Assessment of the role of radiologic studies in the detection of significant urologic anomalies in boys with acute epididymitis.
  23. Tracy C, Steers W, Costabile R. Diagnosis and management of epididymitis. Urol Clin North Am. 2008;35:101-8; vii pubmed
    b>Epididymitis is a common and morbid condition seen across a wide age range. There are multiple etiologies that may lead to inflammation of the epididymis, including infection, trauma, autoimmune disease, and vasculitis...
  24. Klin B, Zlotkevich L, Horne T, Efrati Y, Serour F, Lotan G. Epididymitis in childhood: a clinical retrospective study over 5 years. Isr Med Assoc J. 2001;3:833-5 pubmed
    Acute scrotal pain in children presents a major diagnostic and therapeutic challenge. Epididymitis has been considered uncommon in childhood...
  25. Cao D, Li Y, Yang R, Wang Y, Zhou Y, Diao H, et al. Lipopolysaccharide-induced epididymitis disrupts epididymal beta-defensin expression and inhibits sperm motility in rats. Biol Reprod. 2010;83:1064-70 pubmed publisher
    ..Using a rat model of epididymitis induced by lipopolysaccharide (LPS), we examined expression of SPAG11E (also known as Bin1b), a caput ..
  26. Hori S, Tsutsumi Y. Histological differentiation between chlamydial and bacterial epididymitis: nondestructive and proliferative versus destructive and abscess forming--immunohistochemical and clinicopathological findings. Hum Pathol. 1995;26:402-7 pubmed
    ..EC) antigens were sought in routinely prepared paraffin-embedded sections from 31 cases of acute and chronic epididymitis by indirect immunoperoxidase staining...
  27. González Jiménez M, Villanueva Díaz C. Epididymal stereocilia in semen of infertile men: evidence of chronic epididymitis?. Andrologia. 2006;38:26-30 pubmed
    ..These data suggest that a silent chronic infection of the epididymis by C. trachomatis, M. hominis, U. urealyticum and/or inflammation produced by varicocele might be the cause of stereocilia loss in the semen...
  28. Trojian T, Lishnak T, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009;79:583-7 pubmed
    b>Epididymitis and orchitis are commonly seen in the outpatient setting. Men between 14 and 35 years of age are most often affected, and Chlamydia trachomatis and Neisseria gonorrhoeae are the most common pathogens in this age group...
  29. Liu H, Fu Y, Wu C, Sun G. Tuberculous epididymitis: a case report and literature review. Asian J Androl. 2005;7:329-32 pubmed
    Tuberculous epididymitis is a rare urological disease difficult to diagnose. The conventional methods for diagnosis are often time-consuming and invasive...
  30. Drury N, Dyer J, Breitenfeldt N, Adamson A, Harrison G. Management of acute epididymitis: are European guidelines being followed?. Eur Urol. 2004;46:522-4; discussion 524-5 pubmed
    Acute epididymitis is increasing in men aged 35 years or under due to sexually-transmitted Chlamydia trachomatis...
  31. Vicari E, La Vignera S, Castiglione R, Calogero A. Sperm parameter abnormalities, low seminal fructose and reactive oxygen species overproduction do not discriminate patients with unilateral or bilateral post-infectious inflammatory prostato-vesiculo-epididymitis. J Endocrinol Invest. 2006;29:18-25 pubmed
    We have shown that patients with prostato-vesiculo-epididymitis (PVE) have the worst sperm output compared to patients with prostato-vesiculitis or prostatitis alone...
  32. Bizimi V, Balanika A, Motogna Kalokairinou M, Paianidi I, Kardamis S, Kominis C, et al. Focal, asymptomatic epididymal masses--B-mode and color Doppler sonographic evaluation. Case report. Med Ultrason. 2010;12:163-6 pubmed
    ..The importance of B-mode and color Doppler sonography in the differential diagnosis and literature regarding epididymal nodules and tumors of the paratesticular structures (epididymis) is reviewed and discussed...
  33. Yen C, Lee C, Su C, Lo H. Malignant mesothelioma of the tunica vaginalis testis: a malignancy associated with recurrent epididymitis?. World J Surg Oncol. 2012;10:238 pubmed publisher
    A 53-year-old Taiwanese male had several episodes of left epididymitis with hydrocele refractory to antibiotic treatment...
  34. Yusuf G, Sellars M, Kooiman G, Diaz Cano S, Sidhu P. Global testicular infarction in the presence of epididymitis: clinical features, appearances on grayscale, color Doppler, and contrast-enhanced sonography, and histologic correlation. J Ultrasound Med. 2013;32:175-80 pubmed
    b>Epididymitis is common, presenting indolently with unilateral scrotal pain and swelling. Diagnosis is based on clinical assessment and resolves with antibiotic therapy...
  35. Shigehara K, Kobori Y, Amano T, Takemae K. [Bilateral tuberculous epididymitis after intravesical Bacillus Calmette-Guerin therapy]. Hinyokika Kiyo. 2005;51:839-42 pubmed
    We describe a case of bilateral tuberculous epididymitis that occurred two weeks after intravesical Bacillus Calmette-Guerin (BCG) instillation...
  36. Chim H, Yam A, Yong F. Re: multifocal deep space hand infection secondary to haematogenous spread from chronic epididymo-orchitis. J Hand Surg Eur Vol. 2008;33:221-2 pubmed publisher
  37. Easley S, MacLennan G. Vasitis and epididymitis nodosa. J Urol. 2006;175:1502 pubmed
  38. Svec A, Mikyskova I, Hes O, Tachezy R. Human papillomavirus infection of the epididymis and ductus deferens: an evaluation by nested polymerase chain reaction. Arch Pathol Lab Med. 2003;127:1471-4 pubmed
    ..We inferred from our previous observation of HPV-31 in epididymal tissue in a case of chronic epididymitis that HPV might be commonly present in cases of epididymitis caused by sexually transmitted pathogens.
  39. Weidner W, Colpi G, Hargreave T, Papp G, Pomerol J, Ghosh C. EAU guidelines on male infertility. Eur Urol. 2002;42:313-22 pubmed
  40. Chand P, Sadana J, Malhotra A. Epididymo-orchitis caused by Brucella melitensis in breeding rams in India. Vet Rec. 2002;150:84-5 pubmed
  41. Sachdev R, Roy S, Jain S. Tubercular epididymo-orchitis masquerading as testicular malignancy: an interesting case. Acta Cytol. 2008;52:511-2 pubmed
  42. Al Omar M, Kwan K, Tweedie E, Luke P. Aggressive angiomyxoma of the epididymis. Can J Urol. 2005;12:2772-3 pubmed
    ..We report a case of aggressive angiomyxoma arising from the epididymis of a young male, which was treated by radical orchiectomy...
  43. Kato H, Igawa Y, Furuya S, Nishizawa O. Müllerian duct remnant involving Wolffian system: a case report and literature review. Hinyokika Kiyo. 2005;51:339-42 pubmed
    A 14-month-old boy with repeated left acute epididymitis was admitted to our department. Ultrasonography detected a midline round cystic mass in a retrovesical region...
  44. Ciftci A, Senocak M, Tanyel F, Buyukpamukcu N. Clinical predictors for differential diagnosis of acute scrotum. Eur J Pediatr Surg. 2004;14:333-8 pubmed
    ..Therefore, differential diagnosis of acute scrotum, particularly TT, still remains a clinical diagnosis, and clinical parameters deserve more importance in surgical decision making...
  45. Cesur S, Ciftci A, Sözen T, Tekeli E. A case of epididymo-orchitis and paravertebral abscess due to brucellosis. J Infect. 2003;46:251-3 pubmed
    ..Infection 1992; 20: 38-42). Brucellosis accompanied by paravertebral abscess and epididymo-orchitis is extremely rare. In this report, we present a case of epididymo-orchitis and paravertebral abscess due to brucellosis...
  46. Lara Ricalde R, Velázquez Ramírez N, Reyes Muñoz E. [No-scalpel vasectomy. Profile of acceptance and results]. Ginecol Obstet Mex. 2010;78:226-31 pubmed
    ..Men have few effective methods for birth control. The surgical method vasectomy is highly safe and effective, although in Mexico represents only 2.4% of all contraceptive methods used...
  47. Junnila J, Lassen P. Testicular masses. Am Fam Physician. 1998;57:685-92 pubmed
    ..or "must not miss" diagnoses associated with testicular masses, including testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer...
  48. Matteelli A, Schlagenhauf P, Carvalho A, Weld L, Davis X, Wilder Smith A, et al. Travel-associated sexually transmitted infections: an observational cross-sectional study of the GeoSentinel surveillance database. Lancet Infect Dis. 2013;13:205-13 pubmed publisher
    ..We aimed to describe the range of diseases and the demographic and geographical factors associated with the acquisition of travel-related STIs through analysis of the data gathered by GeoSentinel travel medicine clinics worldwide...
  49. Memish Z, Venkatesh S. Brucellar epididymo-orchitis in Saudi Arabia: a retrospective study of 26 cases and review of the literature. BJU Int. 2001;88:72-6 pubmed
    ..To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously...
  50. Sawyer E, Anderson J. Acute epididymitis: a work-related injury?. J Natl Med Assoc. 1996;88:385-7 pubmed
    ..Occasionally, this involves a sudden onset of acute epididymitis in the male employee after strenuous activity in the workplace...
  51. La Vignera S, Vicari E, Condorelli R, D Agata R, Calogero A. Male accessory gland infection and sperm parameters (review). Int J Androl. 2011;34:e330-47 pubmed publisher
    ..groups the following different clinical categories: prostatitis, prostate-vesiculitis and prostate-vesiculo-epididymitis. Some of the characteristics they share are: common diseases, mainly have a chronic course, rarely cause ..
  52. Thomas A, Woodard C, Rovner E, Wein A. Urologic complications of nonurologic medications. Urol Clin North Am. 2003;30:123-31 pubmed
    ..It is incumbent on the practicing urologist to be able to recognize the common, and sometimes subtle, urologic complications of medications that are used for nonurologic conditions...
  53. Gallego Vilar D, Povo Martín I, Gimeno Argente V, Bosquet M, Rivadulla Serrano I, Martinez Ramos D, et al. [Brucella spp orchiepididymitis]. Arch Esp Urol. 2008;61:442-4 pubmed
    ..To report a brucellar orchiepididymitis case and to review the diagnosis and treatment of this pathology...