Greater Boston Urology Blog

A Blunder Down Under: A No-Nonsense Guide to Testicular Infections (Epididymitis & Orchitis)

Today, Dr. Natalya Lopushnyan joins us to discuss testicular infections, specifically epididymitis and orchitis. She's going to cover symptoms, treatment, and preventive care.

As with all content on our blog, the following is educational only, not medical advice. Always consult your physician about your specific healthcare needs.

Without further ado, here's Dr. L, as her patients affectionately call her, in her own words.

What is Epididymitis and Orchitis?

Let's talk balls, fellas. Not literally (unless you're into that—no judgment). I'm talking about the guys downstairs who keep the whole baby-making operation running: the testicles. These unsung heroes deserve some attention, especially when things go south, like with infections. So, buckle up for a crash course on two common testicular troublemakers: epididymitis and orchitis.

Understanding orchitis

This one involves the whole entire testicle as it gets inflamed and swollen. It can feel like a heavy, throbbing mass, and the pain can be intense. Fever, nausea, and vomiting might join the party too. The skin can and usually does get red and tender to the touch. Even wearing underwear may be painful. (No shame in going commando!)

Understanding epididymitis

pic for testis infection blog postEpididymitis is similar, yet different. The epididymis is essentially a mohawk that sits on the top of the testicle. While the sperm is made in the testicle, it finishes maturation in the epididymis. Think of it as a bus stop where sperm waits and matures before its ejaculation journey.

The epididymis is made of tiny little tubules (pipes) filled with maturing sperm. If infection gets into it, it tends to cause inflammation, plug those tiny tubes, and lead to significant discomfort (read eye-bulging pain since it's your beloved privates).


Both orchitis and epididymitis can manifest as the following symptoms and signs:

  • Pain: Like someone's trying to twist your jewels with a rusty wrench.
  • Swelling: Your boys might look like they've been stung by a particularly grumpy bee.
  • Fever and chills: Because your body's like, "Yo, something's funky down there! I must fight it!"
  • Discharge: From the penis, or if skin gets infected, even from the skin.

What causes these party crashers? Bacteria are usually the culprits, often sneaking in from urinary tract infections or sexually transmitted infections (STIs). Sometimes, even vigorous exercise or trauma to the area can trigger an infection.

Usually, testis infections are seen in two specific populations:

  1. Patients with history of STDs which then will cause epididymitis/orchitis.
  1. Men who are not emptying their bladders well or have problems urinating (such as slow stream and having to push). In this case, if the bladder does not empty after urination, that left over urine is a great place for bacteria to grow and cause infection of the bladder and sometimes testis.

How do we treat testis infections?

So, what do you do if your boys are throwing a tantrum? Don't panic! Most testicular infections are treatable with antibiotics and some TLC.

Here's the game plan:

  • See a doctor: They'll figure out what's causing the ruckus and get you the right meds.
  • Rest up: Give your boys a break from bouncing around.
  • Ice or heat: Cold packs can help ease the swelling and pain; warm packs may make the pain a little better. Use whatever works best for you.
  • Support your sack: Scrotal support or tight, spandex, athletic underwear can take some pressure off. When the scrotum and testis are hanging low, gravity takes over causing more swelling. It also stretches the nerves that go to the testis causing more pain.
  • Anti-inflammatory medications: ibuprofen and naproxen are helpful in calming down your boys and making pain a little better until you see a doc.
  • Stay hydrated: This helps flush out the bad guys.


  • The longer you wait to seek medical treatment, the longer the treatment will take. If uncomplicated, epididymitis/orchitis usually clears up in a week or two. An infection that was left untreated for a while may require a month of antibiotics and other medications.
  • Don't be shy about talking to your doctor, even if things feel embarrassing. About 50% of the population have balls, so this condition is nothing out of the ordinary.
  • Practice safe sex to lower your risk of sexually transmitted infections.
  • Make sure you are urinating well. If you have slow stream, going to the bathroom all the time, waking up many times at night to urinate, or have to push when you pee, you may not be emptying your bladder well and putting yourself at a higher risk for infection.
  • Listen to your body and take it easy if something feels off.

Your boys work hard to keep your testis functioning smoothly. So, take care of them! With a little knowledge and TLC, you can keep your testicular troubles at bay and keep those swimmers doing their victory laps.

Bonus tip: Keep your boys cool and comfy! Don't squeeze them too much with tight pants but provide plenty of support with athletic underwear during sports and exercise.

I hope this informative and lighthearted approach to a sensitive topic is helpful and accessible!

Concerned about your testicular health?

Make an appointment with Dr. Lopushnyan or one of our other world-class urologists.

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