Can epididymorchitis cause sterility?

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Last updated: June 10, 2025View editorial policy

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From the Guidelines

Epididymorchitis can potentially cause sterility if left untreated or not managed properly, as it may lead to complications such as infertility or chronic pain. Epididymorchitis is an inflammation of the epididymis and testicle that can lead to fertility problems if not treated promptly and effectively. The risk of sterility increases with severe or recurrent infections, bilateral involvement (affecting both testicles), or delayed treatment. According to the 1998 guidelines for treatment of sexually transmitted diseases by the Centers for Disease Control and Prevention 1, treatment of epididymitis caused by C. trachomatis or N. gonorrhoeae can prevent complications such as infertility.

Key points to consider in the management of epididymorchitis to prevent sterility include:

  • Prompt treatment with antibiotics, such as ciprofloxacin or doxycycline, for 10-14 days
  • Completing the full course of antibiotics to prevent complications
  • Pain management with NSAIDs like ibuprofen
  • Scrotal support and rest to reduce inflammation
  • Seeking medical attention within 24-48 hours of symptom onset to reduce the risk of permanent fertility damage. The underlying mechanism involves inflammatory damage to the delicate tubules of the epididymis, which can lead to obstructive azoospermia if scarring occurs, as suggested by the potential complications mentioned in the guidelines 1.

It is essential to note that the risk of sterility can be minimized with prompt and effective treatment, emphasizing the importance of seeking medical attention early in the course of the disease.

From the Research

Epididymorchitis and Sterility

  • Epididymorchitis is an inflammation of the epididymis that can lead to various complications, including sterility 2.
  • According to a study, about 40 out of 100 patients develop post-inflammatory sub-fertility, indicating a potential link between epididymorchitis and sterility 2.
  • The study also mentions that virulence factors like haemolysin A produced by uropathogenic E. coli have a negative impact on semen parameters, which can contribute to sterility 2.

Causes and Risk Factors

  • Epididymorchitis can be caused by various factors, including bacterial infections, sexually transmitted infections, and urinary tract pathogens 3, 4, 5.
  • The risk of sterility may be higher in cases where the infection is left untreated or is caused by certain types of bacteria, such as those that produce haemolysin A 2.

Treatment and Prevention

  • Early diagnosis and treatment of epididymorchitis are essential to prevent complications, including sterility 4, 5.
  • Antibiotic treatment can help reduce the risk of sterility, and in some cases, prophylactic vasectomy may be recommended to prevent further complications 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Current Aspects of Epididymo-Orchitis].

Aktuelle Urologie, 2016

Research

The 2016 European guideline on the management of epididymo-orchitis.

International journal of STD & AIDS, 2017

Research

Epididymitis: An Overview.

American family physician, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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