The epididymis is a small, rectangular-shaped, cordlike structure, resting on top of and beside the testes. Epididymo-orchitis is an inflammatory process of the epididymis that spreads to the testes.

Most cases of epididymitis and resulting epididymo-orchitis stem from complications of infections, and can be divided into two categories that involve different age groups and etiologies. Sexually transmitted types generally occur in men under the age of forty, are related to urethritis, and result from specific organisms, e.g., Chlaymidia trachomatis. Nonsexually transmitted types generally occur in older men, are related to urinary tract infection (UTI) and prostatitis, and are caused by gram-negative organisms.

Manifestations of epididymitis and epididymo-orchitis include: fever and chills; pain in the inguinal region; swelling of the epididymis, or testes or both; tender prostate gland; vomiting; hiccough; and delirium. Manifestations associated with urethritis may include pain at the end of the penis and discharge. Signs associated with cystitis may include burning on urination.

A physical examination with blood tests is indicated, as well as urinalysis and urine cultures to identify the causative organism. In addition, a scrotal ultrasound may assist in the diagnosis.

Treatment is directed toward identifying the causative agent to determine appropriate antibiotic therapy, elevating the scrotum, and treating the underlying infectious process with antibiotics.

Timely treatment usually results in a favorable outcome. However, a decrease in fertility or abscess formation may occur. Wasting away (atrophy) of the testicle may be an end result.

• This disease, (condition), only in its active form , has a 3 year presumptive period and shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied. [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

• The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350 (i)(1) – Total plus 60% and – Special Monthly Compensation (SMC).

• A report of the Institute of Medicine of the National Academy of Sciences has identified some long-term health effects, listed in the table embedded within 38 CFR 3.317(d), that potentially are associated with the infectious diseases listed in 38 CFR 3.317(c)(2. These health effects and diseases are listed alphabetically and are not categorized by the level of association stated in the National Academy of Sciences report. If a veteran who has or had an infectious disease identified in column A also has a condition identified in column B as potentially related to that infectious disease, VA must determine, based on the evidence in each case, whether the column B condition was caused by the infectious disease for purposes of paying disability compensation. This does not preclude a finding that other manifestations of disability or secondary conditions were caused by an infectious disease. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases.

• If a veteran presumed service connected for one of the diseases listed in 38 CFR 3.317(c)(2) is diagnosed with one of the diseases listed in column “B” in the table embedded within 38 CFR 3.317(d) within the time period specified for the disease in the same table, if a time period is specified or, otherwise, at any time, VA will request a medical opinion as to whether it is at least as likely as not that the condition was caused by the veteran having had the associated disease in column “A” in that same table. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases.

• For tubercular infections: Rate in accordance with 38 CFR 4.88b or 4.89, whichever is appropriate

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.