The scrotum is the pouch of skin that bears a man's testicles, a very important part of the male reproductive system. It projects downwards and hangs between the legs. It is a very crucial part of the male reproductive system in that it houses the testicles/testes which produce sperm cells just as the ovaries produce eggs in females.

In addition to the sperm produced, the testes produce hormones, basically the testosterone. In the testes, there is a structure that is coiled where the sperm cells are stored. That structure is called the epididymis.

Infections that affect the scrotum are collectively called scrotal conditions. In other words, scrotal conditions are infections within the scrotum. These include infections of the testes and the epididymis. While the infection of the testes is called orchitis, the infection of the epididymis is called epididymitis. These infections are primarily caused by bacteria that are sexually transmitted.


Orchitis can be defined as the inflammation of the testes. One or both testes could be affected. Many conditions can lead to the inflammation of the testes. Orchitis can be caused by sexually transmitted bacteria, which are contracted through vaginal, oral, or anal sex.

Two kinds of bacteria that commonly cause orchitis are Chlamydia trachomatis and Neisseria gonorrhea. It would interest you to know that orchitis is accompanied by the enlargement of the testes, pain, tenderness, hardening of one or both testes, redness of the scrotal skin, swollen scrotum, and enlarged epididymis. Sexually active men are at a great risk of suffering from orchitis.

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Symptoms of orchitis

  • Fatigue
  • Muscle pain
  • Testicular pain
  • A general feeling of weakness
  • Restlessness
  • A headache

Causes of orchitis

Orchitis caused by bacteria is as a result of the spread of the bacteria from the epididymis. The bacteria that are a part of the bacterial infection of the testes are Chlamydia trachomatis and Neisseria gonorrhea.

Complications from orchitis

If left untreated, orchitis can bring about complications that contribute to more challenges and difficulties in a man. These complications include:

  • Testicular atrophy
  • Impaired fertility

Diagnosis of orchitis

In sexually active men, urethral swabs are cultured for Chlamydia trachomatis and Neisseria gonorrhea. Urine culture and urinalysis can also be done to check for any of the bacteria.

Other diagnostic procedures include:

  • Ultrasonography
  • Testicular torsion
  • Surgical drainage

Treatment for orchitis

Orchitis can be treated with antibiotics. The antibiotics recommended by the CDC are:

A combination of Ceftriaxone and doxycycline or,

A combination of Ceftriaxone and azithromycin

Management of orchitis

The following can be done for a patient suffering from orchitis:

  • Placing hot or cold packs on the scrotum
  • Giving him bed rest
  • Elevating the scrotum to reduce pain
  • Prescribing analgesics to reduce pain


This is the inflammation of the epididymis. The epididymis is a long, coiled tube that carries and stores sperm. It is located at the back of the testis. Epididymitis commonly affects males aged 18-50 years.

Symptoms of epididymitis

  • Scrotal pain that starts gradually and becomes chronic
  • Swelling of the scrotum that lasts for days
  • Difficulty in urination
  • Fever
  • Chills
  • Urethral discharge

Epididymitis could be caused by a bacterial infection of which Chlamydia is the most common bacterial infection linked with epididymitis in sexually active men younger than 35. Other bacteria that can cause epididymitis include:

  • Neisseria gonorrhea
  • Treponema pallidum
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Epididymitis is characterized by the tenderness of the epididymal tail, followed by hardening that spreads to other parts of the epididymis. The scrotum may be reddened and inflamed.

Complications from epididymitis

An inflamed epididymis is a sensitive disease condition that, apart from the pain it brings, can cause complications. One of these complications is impaired infertility as a result of further infection of the testes. If left untreated, epididymitis can ruin a man's chances of getting a woman pregnant.

Diagnosis of epididymitis For the diagnosis of epididymitis caused by bacterial infection, a doctor could require urethral swabs for urethral culture and nucleic acid hybridization. These are to detect the presence of Neisseria gonorrhea and Chlamydia trachomatis that induced the infection in the first place.

Treatment for epididymitis

For epididymitis caused by sexually transmitted Chlamydia and Gonorrhea, the Centers for Disease Control and Prevention (CDC) recommend ceftriaxone combined with doxycycline. For men whose penis actively contact the anus during sex, levofloxacin or ofloxacin should replace the doxycycline as a combined therapy with ceftriaxone.

Risk population for scrotal conditions

  • Men who practice anal sex
  • Men who practice unprotected sex
  • Sexually active men
  • Men with multiple sex partners

Prevention of scrotal conditions

  • Get screened for Sexually Transmitted Diseases regularly
  • Use condoms consistently when you have multiple sex partners

Finally, it is important to watch out for the symptoms and this can be done by having a home test kit always at the ready. Remember; prevention is better and cheaper than cure!