Testicular Pain & Swelling: Don't Ignore the Warning Signs
Sudden testicular pain needs urgent assessment. In sexually active men under 35, epididymitis is usually caused by chlamydia or gonorrhoea. Same-day appointments available.
Epididymitis is inflammation of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. In sexually active men under 35, it's most commonly caused by STIs, particularly chlamydia and gonorrhoea. In older men, it's more often related to urinary tract infections or prostate problems. Prompt treatment is essential to prevent complications.
Diagnosis involves physical examination showing tender, swollen epididymis, often with fever. We perform urine tests and urethral swabs for STI screening (chlamydia, gonorrhoea, mycoplasma). Ultrasound may be used to rule out testicular torsion - a surgical emergency that presents similarly. Blood tests may check for signs of infection.
Treatment involves antibiotics targeting the likely cause. For sexually transmitted epididymitis, we typically prescribe ceftriaxone injection plus doxycycline. For UTI-related cases, fluoroquinolones or other antibiotics are used. Supportive care includes rest, scrotal elevation, ice packs, and anti-inflammatory painkillers. Sexual partners need testing and treatment.
It can be if untreated. While most cases resolve with antibiotics, complications include abscess formation, chronic pain, and fertility problems. Importantly, sudden testicular pain needs urgent assessment to rule out testicular torsion, which is a surgical emergency.
With appropriate antibiotics, pain usually improves within a few days, but complete resolution of swelling can take several weeks. It's important to complete the full antibiotic course even if you feel better. Avoid heavy lifting and sexual activity until fully recovered.
If treated promptly, fertility is usually preserved. However, severe or recurrent infections can cause scarring that blocks sperm transport. Bilateral (both sides) involvement carries higher fertility risks. Early treatment is key.
Sudden, severe testicular pain needs urgent assessment to rule out testicular torsion, which requires emergency surgery. If pain developed gradually over hours/days with other symptoms, same-day GP or sexual health clinic assessment is appropriate.
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