Groin pain/epididymitis

Overview

Severe groin pain is often due to either epididymitis or orchitis. The two conditions are closely related and can occur in tandem, at which point the condition is known as epididymo-orchitis.

Epididymitis is a condition in which the epididymis, the coiled tube which stores and carries sperm at the back of the testicle, becomes inflamed. The condition can occur in males at any age. Among the most common causes are bacterial infections, including sexually transmitted infections such as chlamydia and gonorrhea.

Orchitis is a closely related condition in which one or both testicles of your testicles are inflamed. Again, a bacterial infection is the most common cause. That can include sexually transmitted infections, and in some cases, orchitis results from the mumps virus.

Both conditions can cause pain and affect fertility. Epididymitis and orchitis can become chronic conditions, and in some cases, the cause is never fully determined. While medication can treat infections, soreness can persist for several weeks.

Symptoms

For both epididymitis and orchitis, the most common symptoms are:

• Mild to severe pain
• Swelling of the testicles or scrotum
• Pain in the groin scrotum or testicles

Orchitis can lead to fever, nausea, and vomiting. Epididymitis can also cause painful and frequent urination, a discharge from the penis, and blood in the semen.

Diagnosis

The initial examination from the physician will involve checking the abdomen and scrotum, and possibly performing a rectal exam.  This can be caused by a urinary infection, sexually transmitted infection, or may be present without evidence of another infection. Work up usually involves a scrotal ultrasound as well as a urinalysis and culture for infection, as well as evaluation for chlamydia and gonorrhea depending on patient’s history.  

Testicular torsion, where a testicle becomes rotated, is another cause of severe testicular pain. If pain is extremely severe and unrelenting, you should go to the Emergency Department as this is a time sensitive condition that can result in loss of the testicle if not treated quickly. 

Treatment

For both epididymitis and orchitis, the most common course of treatment is antibiotics. These serve to fight the bacterial infections that are the typical cause of these inflammations. In the case of sexually transmitted infections, the patient’s sexual partner will also require treatment.

Relief can begin within two to three days after starting to take the antibiotic treatment. Doctors generally recommend that you can use ice packs to relieve pain during this period. Complete recovery from tenderness can take several weeks.

Surgical Intervention

Epididymitis can lead to the formation of an abscess. In these rare cases, a full or partial epididymectomy can be necessary. That will fully or partially remove the epididymis.

Viral Orchitis

Both bacterial and viral infections can cause orchitis. The most common recommendations for these cases are nonsteroidal anti-inflammatory drugs like ibuprofen. In the case of viral infections, antibacterial medications will have no effect. Rest and ice packs can again serve to reduce pain.

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