Treatment of Epididymitis
The treatment of epididymitis depends on the underlying cause—whether it’s bacterial, sexually transmitted, or non-infectious. Epididymitis is highly treatable, especially when caught early. The main goals are to eliminate infection, relieve pain, and prevent complications.
Antibiotics
Doctors should begin antibiotic treatment as soon as they suspect a bacterial infection. The choice of antibiotic depends on the patient’s age and likely cause:
For sexually active men under 35:
Ceftriaxone (single injection) for gonorrhoea
Plus doxycycline (100 mg twice daily for 7–14 days) for chlamydia
For older men or men with UTIs:
Ciprofloxacin or levofloxacin (oral fluoroquinolones)
Treatment usually lasts 10–14 days
Patients should complete the full course of antibiotics even if symptoms improve early.
Supportive Care
Pain relief – Paracetamol or ibuprofen helps reduce pain and inflammation
Scrotal support – Wearing snug underwear or using a scrotal support sling can relieve pressure
Rest – Bed rest for the first few days can speed up healing
Cold packs – Reduce swelling and provide pain relief
Doctors advise patients to avoid sexual activity until they complete treatment and all symptoms have fully resolved.
Treating Sexual Partners
If a sexually transmitted infection is the cause, doctors must test and treat the patient’s sexual partners as well. Re-infection is common if partners are untreated. In South Africa, public clinics offer free STI treatment and counselling services.
Follow-Up | Treatment of Epididymitis
Most patients improve within 48–72 hours of starting antibiotics. If symptoms persist or worsen, additional testing may be needed to rule out:
Abscess formation
Testicular involvement (orchitis)
Tuberculosis-related epididymitis
In chronic or recurring cases, referral to a urologist is recommended.
The treatment of epididymitis is usually successful with antibiotics and self-care. Early intervention helps avoid long-term issues like infertility or chronic pain.
[Next: Complications of Epididymitis →]
