Epididymitis in Children

What is epididymitis in children?

Epididymitis is an inflammation or infection of the epididymis. The epididymis is a thin, coiled tube that sits on top of a male testicle. It's where sperm are stored and mature. It connects to a tube called the vas deferens. This tube carries sperm to the urethra. The urethra is the single tube where semen and urine leave the body through the tip of the penis. Each testicle has an epididymis and a vas deferens.

What causes epididymitis in a child?

In younger boys, it can be caused by a urinary tract infection. The infection may be linked to a structural problem in the genitourinary system. In older boys and teens, it's often caused by a sexually transmitted infection (STI), which is also called a sexually transmitted disease (STD). It’s most often caused by gonorrhea or chlamydia. These are bacterial infections.

Which children are at risk for epididymitis?

It’s most often seen in teen boys ages 14 and older. Younger children are at risk if they have had a urinary tract infection.

What are the symptoms of epididymitis in a child?

Symptoms can occur a bit differently in each child. They can include:

• Pain and swelling in the testicles

• Fever

• Feeling of heaviness in the testicles

• Fluid leaking from the urethra

• Blood in the semen

• Lump in the testicles

• Pain during urination or ejaculation

The symptoms of epididymitis can seem like other health conditions. Have your child see their healthcare provider for a diagnosis.

How is epididymitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. Your child may also have tests, such as:

• Urine tests. These are to check for bacteria or other problems.

• Ultrasound. This painless imaging test uses sound waves to look at body tissues. This can help find structural problems of the genitourinary system.

How is epididymitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Epididymitis is almost always caused by a bacterial infection. Because of this, the most common treatment is antibiotic medicine. Your child's healthcare provider may also prescribe pain medicine and anti-inflammatory medicine. Other steps to help relieve the pain include raising the scrotum and using ice. Bed rest may also help. 

If your teen has an STI, make sure they tell any sexual partners who had contact within 60 days before symptoms. They need to be treated with medicine. A sexually active teen and their partner should not have sex until both have been treated and no longer have symptoms.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are possible complications of epididymitis in a child?

If not treated, epididymitis can become chronic. This means inflammation, pain, and other symptoms don’t go away. Other possible complications include:

• A pocket of infection (abscess) that may need to be drained

• Infection of the testicle

• Lasting (permanent) injury to the epididymis and testicle

• Fertility problems

How can I help prevent epididymitis in my child?

Epididymitis is often transmitted through sex. Safe sex is the best way to prevent it. Safe sex includes using condoms during sex and not having more than 1 sex partner.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child:

• Does not get better within 72 hours of treatment

• Has symptoms that get worse

• Has new symptoms

Key points about epididymitis in children

• Epididymitis is an inflammation or infection of the epididymis.

• In younger boys, it can be caused by a urinary tract infection. In older boys and teens, it's often the result of a sexually transmitted infection (STI), such as gonorrhea or chlamydia.

• Symptoms can include pain, swelling, fever, and fluid leaking from the urethra.

• The most common treatment is antibiotic medicine.

• A sexually active teen and their partner should not have sex until both have been treated and no longer have symptoms.

• If not treated, epididymitis can become chronic. This means inflammation, pain, and other symptoms don’t go away.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.