Can Telemedicine Treat Epididymitis (Suspected) - Triage?

Audience: pediatric

Epididymitis is an inflammation of the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. It often causes pain, swelling, and sometimes fever in boys and adolescent males. Telemedicine can be a helpful first step to assess symptoms and decide if urgent in-person care is needed. Through video or phone visits, healthcare providers can ask about symptoms, examine visible signs, and guide families on next steps. However, some cases require a physical exam, tests, or treatments that must be done in person. If symptoms are severe or worsening, telemedicine can quickly direct families to emergency care. This guide explains when telemedicine is suitable for suspected epididymitis in pediatric patients, what to expect during a tele-visit, and important warning signs that need prompt attention.

Red flags — go in person / ER

• Severe or sudden testicular pain—seek emergency care immediately as this may indicate testicular torsion.
• High fever (above 38.5°C or 101.3°F) with worsening scrotal swelling or redness—contact healthcare provider urgently.
• Redness or swelling spreading beyond the scrotum, or signs of severe illness such as vomiting or difficulty urinating—seek prompt medical attention.

What telemedicine can do

• Initial symptom assessment and triage for suspected epididymitis in pediatric patients.
• Providing guidance on symptom monitoring and home care.
• Determining if urgent in-person evaluation is necessary.
• Answering questions about the condition and treatment options.

What telemedicine cannot do

• Performing physical examination including palpation of the testicles.
• Ordering or conducting diagnostic tests such as ultrasound or urine analysis.
• Administering treatments that require in-person visits, such as injections or surgical interventions.
• Managing severe or rapidly worsening symptoms requiring emergency care.

What is Epididymitis?

Epididymitis is swelling and inflammation of the epididymis, which is a small tube behind each testicle. It helps store and carry sperm. This condition can cause pain, tenderness, and swelling in the scrotum. It may also cause fever or discomfort when urinating. In children and teens, epididymitis is often caused by infections, including urinary tract infections or sexually transmitted infections in older adolescents.

How Telemedicine Can Help

Telemedicine allows healthcare providers to evaluate your child's symptoms remotely using video or phone calls. During the visit, the provider will ask about the pain, swelling, fever, and any other symptoms. They can look for visible signs through video and guide you on how to check for tenderness or swelling safely at home. Telemedicine can help decide if your child needs urgent in-person care or if home care and follow-up are appropriate.

When In-Person Care is Needed

Some situations require a physical exam, tests, or treatments that cannot be done remotely. If your child has severe pain, high fever, redness spreading on the scrotum, or other concerning signs, they should be seen in person quickly. In-person care may include ultrasound imaging, urine tests, or antibiotics prescribed after a full exam. Emergency care is needed if there is sudden, severe testicular pain or swelling, which could signal testicular torsion—a medical emergency.

Preparing for a Telemedicine Visit

Before the tele-visit, make sure you have a quiet, private space with good lighting. Have your child's medical history ready, including any past infections or urinary problems. Be prepared to describe symptoms clearly, including when they started and how severe they are. Have a list of any medications your child is taking. If possible, have a way to show the affected area on video safely and respectfully.

After the Telemedicine Visit

Follow the healthcare provider's advice carefully. This may include giving medications, monitoring symptoms, or scheduling an in-person visit. Keep track of any changes in pain, swelling, or fever. If symptoms worsen or new symptoms develop, seek in-person care promptly. Keep all follow-up appointments and ask questions if you are unsure about care instructions.

How to prepare for your tele-visit

• Find a private, well-lit space for the telemedicine visit.
• Have your child’s medical history and symptom details ready.
• Prepare a list of current medications your child is taking.
• Be ready to describe the onset, location, and severity of symptoms.
• Have a device with a camera for video if comfortable and safe to show affected area.
• Ensure a stable internet or phone connection for the visit.

After your tele-visit

• Follow the healthcare provider’s instructions carefully regarding medications and symptom monitoring.
• Watch for any worsening symptoms or new warning signs and seek in-person care if needed.
• Schedule any recommended follow-up appointments or tests.
• Keep a symptom diary to share with healthcare providers if symptoms persist.
• Ask questions if you do not understand care instructions or if your child’s condition changes.

FAQs

What causes epididymitis in children and teens?

Epididymitis in children and adolescents is often caused by infections, such as urinary tract infections or, in sexually active teens, sexually transmitted infections. Sometimes, it can occur after injury or other medical conditions affecting the urinary tract.

Can antibiotics be prescribed through telemedicine?

In some cases, healthcare providers may prescribe antibiotics after a telemedicine visit if they are confident in the diagnosis. However, many times an in-person exam and tests are needed before starting antibiotics for epididymitis.

How can I tell if my child needs emergency care?

If your child has sudden, severe testicular pain, high fever, spreading redness or swelling, difficulty urinating, or feels very unwell, seek emergency medical care immediately. These could be signs of serious conditions like testicular torsion or severe infection.

Is epididymitis contagious?

Epididymitis itself is not contagious, but some infections causing it, such as sexually transmitted infections, can be passed to others. It’s important to follow healthcare advice about treatment and prevention.

How long does epididymitis usually take to get better?

With proper treatment, symptoms often improve within a few days to weeks. However, some cases may take longer to fully resolve. Follow your healthcare provider’s guidance and complete all prescribed treatments.

Sources

1. Epididymitis — MedlinePlus, U.S. National Library of Medicine.
2. Epididymitis and Orchitis — Mayo Clinic.
3. Epididymitis — Centers for Disease Control and Prevention (CDC).
4. Pediatric Epididymitis — American Academy of Pediatrics.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or you have concerns, seek immediate medical attention.