Last updated: May 18, 2026
Another common infection-relatively at the genitalia for Gentleman, that is so called- testicular infection which made patients come to see me along with the painful and swelling at his balls. As we knew that a simple men has 2 testes in his scrotal sac, but it is very uncommonly to be infected both of them at a single time. Actually, it is not only the testicle organ that I want to talk or mention by now, the infection of testicle mostly involved and relates to the other organs that called Epididymis.
The Epididymis is a tubular structure attached to the posterior and superior side of each testicle where the sperm maturing before ejaculation. Regards to this both organs lie very adjacent so the infection often affects of this both organs and the medical term called it the “Epididymo-orchitis”.
Sound likes the bladder infection; the major causes of this kind of infection happens from retrograde bacterial gliding from the urethra, another which very commonly is a sexually transmitted disease referred to Chlamydia and Gonorrhea. Occasionally, testicular infection can also be derived from repetitive physical activities.
After the completion of evaluating, treatments will be based on the suspicious causes and symptoms which majoring divided into 2 options
Testicular infection treatment depends on the causation.
- Bacterial infection – Oral Fluoroquinolones antibiotic course is recommended. The antibiotic is readjusted based on the specific pathogen identified from urine culture.
- STDs – Also another possibly cause of testicular infection. Proper cocktail therapies are needed to completely eradicate Chlamydia and Gonorrhea infection.
Pain control can be well-managed with anti-inflammatory drugs and ice packs. It is good to tell the patients that if treatment is on the right track, pain will be relieved first, but scrotal swelling may take months to fully recover.
It’s important to identify the underlying cause once the patient starts improving. Prevention counseling should include water drinking habits, safe sex practices to prevent STDs, and assessment of any anatomical abnormalities.
The most important thing before diagnosing testicular infection is to first rule out testicular torsion – an urgent urological emergency that requires immediate surgical correction. Delayed treatment risks permanent loss of the testicle. If you are suffering from this kind of problems, you better seek out the trusted urologic advice or would be honor if you text me.
If you have painful or swollen testicles and would like proper diagnosis and treatment, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Book a Consultation.
Frequently Asked Questions about Testicular Infection (Epididymo-Orchitis)
Epididymo-orchitis is an infection involving both the epididymis and the testicle. The epididymis is a coiled tube attached to the back of each testicle where sperm mature. Because the two structures lie closely together, infection often spreads to affect both simultaneously, resulting in pain, swelling, and tenderness of the affected side of the scrotum.
Testicular infection most commonly results from bacteria spreading retrograde from the urethra or urinary tract, with E. coli being the most frequent culprit in older men. In younger sexually active men, sexually transmitted infections such as Chlamydia trachomatis and Neisseria gonorrhoeae are the leading causes. Rarely, heavy physical exertion or anatomical abnormalities can also trigger the condition.
Treatment depends on the suspected cause. Bacterial epididymo-orchitis is treated with oral fluoroquinolone antibiotics, adjusted based on urine culture results. STD-related epididymo-orchitis requires a combination antibiotic regimen targeting both Chlamydia and Gonorrhea. Supportive care includes anti-inflammatory medications, scrotal elevation, and ice packs for pain and swelling relief.
With appropriate treatment, pain typically improves within a few days. However, scrotal swelling can persist for several weeks to months even after the infection has been eradicated. This is normal and does not necessarily indicate treatment failure. Follow-up with your urologist is important to confirm full resolution and rule out complications such as abscess formation.
Testicular torsion and epididymo-orchitis can present similarly with acute scrotal pain and swelling, but torsion is a surgical emergency requiring immediate intervention to save the testicle. Torsion typically has a sudden onset in younger males without fever or urinary symptoms, while infection is more gradual with fever and often associated urinary complaints. Urgent ultrasound can help differentiate them. If in doubt, seek emergency urological evaluation immediately.
Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.
Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).
Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.
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