Overview of Epididymitis and Orchitis
Epididymitis is inflammation of the epididymis, which is a structure located on top of each testicle (testis). The epididymes are an important part of the sperm development process and are more prone to infection than the testicles.
Orchitis, inflammation of the testicles, usually results from the spread of infection from the epididymis. Most cases of isolated orchitis (i.e., orchitis that develops without epididymitis) are a symptom of the mumps (a viral infection that usually begins in the salivary glands). When epididymitis and orchitis occur together, it is called epididymo-orchitis.
These conditions cause inflammation and pain that is often limited to one, but can involve both sides of the scrotum.
Acute epididymitis, orchitis, and epididymo-orchitis cause sudden pain that usually responds well to treatment. Chronic conditions cause pain that develops gradually and can be more difficult to treat. Acute and chronic cases may result in male fertility problems or testosterone deficiency.
Incidence and Prevalence of Epididymitis and Orchitis
Acute epididymitis is common in young men, and can affect males of any age. Orchitis and chronic conditions are less common. According to the U.S. Centers for Disease Control and Prevention (CDC), epididymitis is especially common in young sexually-active men and is the most common cause of acute (severe) scrotal pain in adolescent males.
In 2004, the CDC noted that approximately one-third of postpubertal (sexually mature) males with mumps develop mumps orchitis, which is the primary cause of isolated orchitis. However, in a 2006 outbreak of mumps in the United States, about 50% of infected postpubertal males developed mumps orchitis, according to the CDC. Mumps is rare in the United States, due to a widely available vaccine, but occasional outbreaks do occur. It is a common disease outside of the United States.
Overview of Testicular Pain
Testicular pain, or any pain in one or both sides of the scrotum (sac that holds the testicles), should be taken seriously. Pain in the scrotum can occur in males of any age, including newborns. The testicles, or testes, are the two male reproductive glands that produce sperm. These glands are very sensitive and even a minor injury can cause pain or discomfort. Many types of testicular or scrotal pain need medical attention.
Testicular or scrotal pain that is sudden or severe, pain that is associated with a puncture wound, pain that occurs with swelling after an injury and lasts more than one hour, and pain that is accompanied by nausea or vomiting are emergencies and require immediate medical attention.
Pain or tenderness in the scrotum that is associated with a lump, fever, unusual warmth or redness, blood in urine (hematuria), unusual discharge from the urethra, mumps exposure, or chronic pain should be reported to a doctor as soon as possible. If untreated, some conditions can lead to infertility, erectile dysfunction (ED), severe or chronic pain, or cause tissue death that may make removal of the testicle necessary.
Anatomy of the Testicle
In some cases, the actual source of testicular pain is not the testicles, but a structure located in the scrotal region. The testes, or testicles, are the two male reproductive glands that produce sperm. Located above each testicle is an epididymis, another important part of the sperm development process. The epididymes are more prone to infection than the testicles. The scrotum is the sac that holds and protects the testes and epididymes. The perineum is the area between the scrotum and the anus.
Groin is a term often mistakenly used interchangeably with testicles or scrotum. However, groin technically refers to the fold or line between the abdomen and inner thigh, and the term may also be used to refer to this general region.