[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Lower urinary tract and male genital system](https://durgical.com/en/general-pathology/areas/urinary-male/) › Epididymitis, orchitis and prostatitis # Epididymitis, orchitis and prostatitis - Lesion Infection usually reaches the epididymis first; mumps and syphilis prefer the testis; prostatitis can be acute, chronic or granulomatous. Updated Nov 12, 2026 ## Key points - Age guide: young sexually active men — Chlamydia, gonorrhea; older men — E. coli and Pseudomonas from urinary infection. - Mumps orchitis: after puberty, usually unilateral; atrophy, rarely sterility. - Tuberculosis: caseating granulomas in the epididymis first, then testis and prostate. - Syphilis: orchitis first; gummas or diffuse interstitial inflammation with plasma cells and obliterative endarteritis. - Acute bacterial prostatitis: fever, perineal pain, tender boggy prostate; chronic abacterial pelvic pain is the commonest form. - Granulomatous prostatitis after BCG instillation, from infections, or nonspecific after ductal rupture. ## What it is Inflammation of the male genital organs usually comes from the urinary tract or sexual transmission. Epididymitis is more common than orchitis. Under 35 the usual causes are Chlamydia trachomatis and Neisseria gonorrhoeae; in older men, gut organisms from urinary infections. Mumps causes orchitis after puberty. Tuberculosis begins in the epididymis; syphilis begins in the testis. Granulomatous (autoimmune) orchitis causes a painful mass in middle-aged men. Prostatitis is acute bacterial, chronic bacterial, chronic abacterial (pelvic pain syndrome) or granulomatous, including after intravesical BCG. ## Structure - Nonspecific epididymitis: congestion, edema and neutrophils, then abscesses; healing leaves fibrosis that can block the duct. - Granulomatous orchitis: noncaseating granulomas within tubules and interstitium. - Mumps: interstitial edema with lymphocytes, tubular damage and later focal atrophy. - Prostatitis: neutrophils in acini and stroma; chronic forms show lymphocytes, plasma cells and macrophages. ## Infections and inflammation of male genital organs | Disorder | Where it starts | Clue | | --- | --- | --- | | [Nonspecific epididymitis](https://durgical.com/en/conditions/epididymitis/) | Epididymis | Age-related organisms; scarring can cause infertility | | Granulomatous (autoimmune) orchitis | Testis | Painful mass in middle age; noncaseating granulomas | | [Mumps orchitis](https://durgical.com/en/conditions/mumps/) | Testis | After puberty, with or after parotitis | | [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/) | Epididymis | Caseating granulomas, may spread from the kidney | | [Syphilis](https://durgical.com/en/conditions/syphilis/) | Testis | Gummas, plasma cells, endarteritis | | [Prostatitis](https://durgical.com/en/conditions/prostatitis/) | Prostate | Acute fever and tender gland, or chronic pelvic pain | ## Clinical notes - Epididymitis gives gradual pain relieved by lifting the testis; torsion gives sudden pain and must be excluded urgently. - In Colombia tuberculosis remains frequent and genital involvement can mimic a tumour. ## Memory aid TB climbs into the tail (epididymis), syphilis goes for the testis, mumps waits for puberty. ## Test yourself Think of the answer, then tap the question to see it. ## What are the usual causes of epididymitis in a 25-year-old man? Sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae. ## Which infection starts in the testis rather than the epididymis? Syphilis. ## Which treatment for bladder cancer can cause granulomatous prostatitis? Intravesical BCG instillation. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/epididymitis-orchitis-and-prostatitis/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Granulomatous inflammation: caseating vs non-caseating, the causes to know](https://durgical.com/en/general-pathology/granulomatous-inflammation-caseating-vs-non-caseating-the-causes-to-know/) ## Connections ## Related 4 - [Diseases of the urethra](https://durgical.com/en/general-pathology/diseases-of-the-urethra/) - [Testicular torsion](https://durgical.com/en/general-pathology/testicular-torsion/) - [Seminoma and spermatocytic tumour](https://durgical.com/en/general-pathology/seminoma-and-spermatocytic-tumour/) - [Granulomatous inflammation: caseating vs non-caseating, the causes to know](https://durgical.com/en/general-pathology/granulomatous-inflammation-caseating-vs-non-caseating-the-causes-to-know/) ## Related conditions 8 - [Epididymitis](https://durgical.com/en/conditions/epididymitis/) - [Prostatitis](https://durgical.com/en/conditions/prostatitis/) - [Mumps](https://durgical.com/en/conditions/mumps/) - [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/) - [Syphilis](https://durgical.com/en/conditions/syphilis/) - [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/) - [Chlamydia infection](https://durgical.com/en/conditions/chlamydia-infection/) - [Urinary tract infection (acute cystitis)](https://durgical.com/en/conditions/urinary-tract-infection/) ## Microorganisms 6 - [Chlamydia trachomatis](https://durgical.com/en/microbiology/chlamydia-trachomatis/) - [Neisseria gonorrhoeae](https://durgical.com/en/microbiology/neisseria-gonorrhoeae/) - [Escherichia coli](https://durgical.com/en/microbiology/escherichia-coli/) - [Mumps virus](https://durgical.com/en/microbiology/mumps-virus/) - [Mycobacterium tuberculosis](https://durgical.com/en/microbiology/mycobacterium-tuberculosis/) - [Treponema pallidum](https://durgical.com/en/microbiology/treponema-pallidum/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Epididymitis](https://www.ncbi.nlm.nih.gov/books/NBK430814/) (StatPearls (NCBI Bookshelf), 2024); [Acute Bacterial Prostatitis](https://www.ncbi.nlm.nih.gov/books/NBK459257/) (StatPearls (NCBI Bookshelf), 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/epididymitis-orchitis-and-prostatitis/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/epididymitis-orchitis-and-prostatitis/