Complications of Epididymitis
The complications of epididymitis can arise when the condition is left untreated, treated too late, or does not respond to medication. Although epididymitis is usually curable, ignoring symptoms can lead to long-term pain and even reproductive health issues.
Chronic Epididymitis
In some cases, inflammation persists after the infection has cleared. This is called chronic epididymitis and may involve:
Ongoing testicular pain or discomfort
Occasional swelling
Pain during ejaculation or prolonged sitting
Emotional distress due to chronic symptoms
Chronic forms are harder to treat and may need long-term anti-inflammatories, nerve pain medication, or physical therapy.
Abscess Formation
Severe bacterial infections can lead to an abscess—a pocket of pus within the epididymis or testicle. Symptoms include:
Severe, localised pain
High fever
Visible swelling that doesn’t improve with antibiotics
Surgical drainage may be required if the abscess does not respond to medication.
Infertility
Long-standing or severe epididymitis can cause scarring in the epididymal ducts, blocking sperm flow. This may result in:
Reduced sperm count
Poor sperm motility
Male factor infertility
Bilateral epididymitis (affecting both testicles) increases the risk. Prompt treatment reduces the chances of fertility problems later.
Testicular Involvement (Epididymo-orchitis)
If the infection spreads to the testicle, the condition becomes epididymo-orchitis. This is more serious and can cause:
Intense pain
Swelling of the entire testicle
Possible damage to testicular tissue
In some cases, this can lead to testicular atrophy (shrinkage) or the need for surgical removal.
Recurrent Infections
Men who do not complete their antibiotic course or who are re-exposed to STIs are at risk of recurring episodes. This can cause cumulative damage and increase the risk of chronic symptoms.
Complications of Epididymitis In South Africa
In South Africa, complications often arise due to delayed presentation. Many men avoid seeking help for genital symptoms due to embarrassment or lack of access to affordable care. Education campaigns and improved access to male health services are essential to reduce the burden of this condition.
Proper hygiene, STI prevention, and early treatment can stop most complications before they begin.
Understanding the complications of epididymitis empowers men to act early, complete treatment, and protect their reproductive health and overall wellbeing.
