Epididymitis and Orchitis Signs and Symptoms

Acute epididymitis, orchitis, and epididymo-orchitis caused by an infection usually results in severe, sudden pain in the testicular area. Pain often starts in the back of one testicle and can spread to the entire scrotal and pelvic area. Symptoms of the original infection (e.g., urinary tract infection, prostatitis), such as painful urination, urinary frequency, discharge from the urethra, and fever, also may be present. Scrotal pain and sensitivity often increase in severity and may lead to swelling, redness, and warmth.

Whenever severe testicular pain develops suddenly, it should be treated as a medical emergency until testicular torsion (blockage or reduction of blood flow to the testicle) is ruled out. Torsion is a rare but very serious condition.

Symptoms of mumps orchitis may include mild to severe testicular pain, swelling, tenderness, lower abdominal pain, fever, and chills. Initial symptoms of mumps, such as glandular swelling and pain in the jaw area, usually appear one week before orchitis symptoms.

Noninfectious cases and chronic cases of epididymitis and orchitis usually cause less severe pain that is limited to the scrotum, and do not cause swelling, redness, or warmth. Chronic cases usually develop gradually and last longer than six months.

Epididymitis/Orchitis Complications

Acute inflammation that recurs can lead to a chronic condition, resulting in chronic pain. In rare cases, epididymitis and mumps orchitis can cause infertility. Chronic cases, untreated cases, and cases involving both sides are more likely to result in infertility.

Tuberculous epididymitis and mumps orchitis can cause testicular atrophy (shrinkage), which may reduce testosterone production in the affected testicle. Testosterone levels are not affected in other cases. Severe cases may lead to an abscess (collection of pus), death of a testicle, or continuous draining through the skin, any of which may require surgery.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 14 May 2007

Last Modified: 14 Sep 2015