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When It’s Tender Behind Your Testicle

A tender lump or mass behind your testicle could be epididymitis-orchitis, an inflammation or infection of this sperm-carrying tube.


What is Epididymitis-orchitis?

Epididymitis-orchitis is marked by inflammation and/or infection of the coiled tube behind the testicle that carries sperm to the vas deferens. This inflammation can form a tender lump or mass behind the testicle.


What are the symptoms of Epididymitis-orchitis?

You may experience the following symptoms:

  • Burning with urination
  • Pain or discomfort
  • Redness of the scrotal skin
  • Tenderness to touch
  • Testicle/scrotal swelling
  • Urinary frequency or urgency

If you experience severe pain, pain associated with nausea/vomiting, fevers/chills, or an abnormal lie of the testicle you should go to the emergency room immediately.


What caused Epididymitis-orchitis?

Epididymitis-orchitis may be associated with urinary tract infection, sexually transmitted diseases, trauma, inflammation, enlarged prostate or urethral scar tissue.


How is Epididymitis-orchitis diagnosed?

What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:

  • During your visit, your doctor will ask you questions regarding your medical history, surgical history, medications, and will perform an exam with focused attention to the groin and genitalia. Your doctor may also ask you information regarding your recent sexual history.

Tests that may be performed during or after your visit:

  • Urinalysis: to evaluate for any blood in the urine or infection
  • Urine culture
  • Post-void residual: the physician will often ask you to void and then check to make sure you are emptying your bladder
  • Scrotal ultrasound: an imaging study looking at the testicle, epididymis, hydrocele sac, and blood flow to and from the testicle
  • Light: Your physician may place a strong light behind the testicle to see whether light passes through. Light will pass through inflammation or swelling but will not pass through a solid mass.


How is Epididymitis-orchitis treated?


  • Anti-inflammatories: Ibuprofen and/or other prescription medication is typically utilized to reduce inflammation. For mild cases, this may be the only treatment
  • Scrotal support: Wearing more supportive underwear will help in decreasing scrotal swelling
  • Antibiotics: If there is concern for urinary tract infection or sexually transmitted disease, antibiotics will often be used

In patients with fevers or worsening symptoms on antibiotics, hospitalization and IV antibiotics may be necessary. Swelling may take four to six weeks to normalize.


In the most severe cases or those associated with large abscesses, surgical exploration and drainage may be necessary. It is rare that this is needed.

Schedule an appointment with a MidLantic Urology Physician near you today!

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