Funiculitis: Understanding Spermatic Cord Inflammation

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Source currency note: This guide reflects medical information reviewed in April 2025. Always confirm current guidance with your healthcare professional.

Quick Answer

Funiculitis is inflammation of the spermatic cord, which supplies blood to the testicles, and is a relatively rare condition. It causes scrotal swelling and tenderness, painful urination, lower abdominal pain and fever. Infections, including STIs, are the most common cause. Treatment depends on the cause and may include antibiotics, NSAIDs and rest. The outlook is good with proper treatment. [4]

What the research says

• Published evidence on funiculitis is limited, mostly to case reports. One case report describes a 54-year-old man with poorly controlled diabetes and end-stage renal failure on hemodialysis who developed a spermatic cord abscess two months after bacterial epididymo-orchitis. It was managed with intravenous antibiotics, ultrasound-guided percutaneous drainage and, later, open incision and drainage of the scrotum, and resolved completely after 2 months. A single case cannot show how common this complication is (Yam and Ng, BMJ Case Reports, 2014).

• STIs, one of the infectious causes, remain common. More than 2.5 million cases of gonorrhea, chlamydia and syphilis were reported to the U.S. Centers for Disease Control and Prevention in 2022, and CDC's 2021 treatment guidelines include updated recommendations for treating gonorrhea and chlamydia, the two STIs most often linked to funiculitis (Hufstetler et al., Journal of Women's Health, 2024; Workowski et al., MMWR Recommendations and Reports, 2021).

What Is Funiculitis?

Funiculitis is a relatively rare cause of inflammation in your spermatic cord, which supplies blood to your testicles. It usually appears alongside inflammation in other nearby parts of the body, such as the epididymis (epididymitis), the testicles (orchitis) or the urethra (urethritis) [4].

Spermatic cord inflammation causes swelling, discomfort and pain in and around the scrotum. Inflammation is your body's way of telling you that something is wrong, so you should visit a healthcare provider [4].

Recognizing the Symptoms

Symptom category	Specific signs
Local symptoms	Swelling and tenderness in the scrotum
Whole-body symptoms	Fever and chills, nausea and vomiting
Urinary and sexual symptoms	Pain when you pee (dysuria) or during sexual intercourse (dyspareunia)
Abdominal symptoms	Lower abdominal pain

Symptoms can develop suddenly or last for six weeks or longer, depending on the type of funiculitis [4].

Causes and Risk Factors

Infectious causes

• Bacterial infections such as E. coli, which may include a urinary tract infection (UTI)

• Viral infections such as the mumps virus

• Sexually transmitted infections (STIs), most commonly chlamydia and gonorrhea

These are cited as common causes of funiculitis [4].

Other causes

• Hernia

• Trauma, such as a blow to the area or surgery

• Tumors in the area

Types of funiculitis

Type	What it means
Acute	Symptoms develop suddenly and get worse, usually from a bacterial or viral infection
Chronic	Symptoms last six weeks or longer; pain may come and go and is usually less severe, often from recurring infections or abnormalities in the cord
Granulomatous	Granulomas form in the cord, usually from an autoimmune disease or a specific type of bacterial infection
Idiopathic	Symptoms develop without any clear cause
Postoperative	Symptoms develop after surgery in the area

Risk factors

Anyone with a spermatic cord can get funiculitis, but your risk increases if you [4]:

• Have inflammation in your epididymis, testicles or urethra

• Have had surgery in the area

• Have unprotected sexual intercourse with multiple partners

• Use a Foley catheter

• Use products that may contain irritants, such as spermicides or lubricants

Complications

In rare cases, funiculitis may cause pus to develop in the spermatic cord, forming a pocket of pus (an abscess). You may need surgery to drain it [4].

How Funiculitis Is Diagnosed

A healthcare provider will review your medical history, ask about your symptoms and perform a physical exam to check for tenderness and swelling. They may recommend more tests to find the cause, so they can recommend the most appropriate treatment [4].

Test	Purpose
Blood tests	Look for signs of infection
Imaging tests	Noninvasive tests such as a pelvic ultrasound or CT scan show detailed images of the spermatic cord and nearby areas
Urinalysis	Looks for bacteria in a urine sample
Urine culture	Checks whether bacteria grow from a urine sample

Treatment and Management

Funiculitis treatment depends on its cause [4].

Medical treatment

• Antibiotics treat bacterial infections. If an STI is the cause, your sexual partner(s) should also get treatment.

• NSAIDs help reduce discomfort, inflammation and pain. Check with a provider before taking them.

• Surgical drainage, rarely, to remove pus from an abscess. A surgeon makes a small incision in the groin, drains the pus and cleans the area, and you may also need antibiotics.

Supportive home care

Measure	How to do it
Ice	Wrap ice or a cold pack in a towel and apply it to reduce swelling, for no longer than 20 minutes at a time
Rest	Lie down as often as possible and elevate your pelvis with pillows under your hips and buttocks
Scrotal support	Tight supportive briefs or a jockstrap support the scrotum and reduce pain from free motion

Outlook and Prevention

With proper diagnosis and treatment, the outlook is good. Funiculitis may be uncomfortable and painful, but it usually doesn't cause long-term problems. Bacterial infections should start to feel better a few days after starting antibiotics, so finish your full course even if you feel better. Physical trauma may take a few days or weeks, and viral infections may take a few weeks [4].

If an STI caused it, refrain from sexual intercourse until the infection clears and let your sexual partner(s) know so they can get tested and treated if needed [4]. You can lower your risk by [4]:

• Avoiding chemicals that may irritate nearby areas of your body

• Getting all recommended vaccines

• Getting STI tests every three to six months if you are sexually active

• Practicing safe sex

• Washing your hands regularly with clean water and soap

When to See a Healthcare Provider

Reach out to a healthcare provider if you develop any funiculitis symptoms. Contact them again if you are treated and your symptoms don't improve. It's not easy to talk about pain around the genitals, but getting an accurate diagnosis and proper treatment helps symptoms go away faster [4].

Conclusion

Funiculitis is a manageable condition that, while painful, usually responds well to treatment once the cause is found. If you have scrotal pain or swelling, see a healthcare provider promptly for a diagnosis and a treatment plan; if the pain is sudden and severe, go to the emergency room right away, because it could be testicular torsion, which needs urgent surgery [4].

Frequently Asked Questions

What is the most common cause of funiculitis?

Infections are the most common cause. Bacterial infections such as E. coli, viral infections such as mumps, urinary tract infections and sexually transmitted infections such as chlamydia and gonorrhea can all lead to inflammation of the spermatic cord. [4]

Is funiculitis a serious condition?

Funiculitis can be painful and uncomfortable, but with proper diagnosis and treatment the outlook is good and it usually doesn't cause long-term problems. In rare cases an abscess (a pocket of pus) can form and may need surgical drainage. [4]

How long does it take to recover from funiculitis?

Recovery depends on the cause. Bacterial infections should start to feel better a few days after starting antibiotics, physical trauma may take a few days or weeks, and viral infections may take a few weeks. [4]

What is the difference between acute and chronic funiculitis?

Acute funiculitis comes on suddenly and gets worse, usually from a bacterial or viral infection. Chronic funiculitis means symptoms for six weeks or longer, with pain that may come and go and is usually less severe, often from recurring infections or abnormalities in the cord. [4]

Do I need surgery for funiculitis?

Rarely. Surgical drainage may be needed only if severe funiculitis leads to an abscess. The surgeon makes a small incision in the groin, drains the pus and cleans the area, and you may also need antibiotics. [4]

Can a hernia cause funiculitis?

Yes. A hernia is one of the other possible causes, along with trauma such as a blow to the area or surgery, and tumors in the area. A provider uses your history, an exam and tests such as imaging to find the cause. [4]

Should my partner be treated if I have funiculitis?

If an STI caused it, your sexual partner(s) should also get treatment from a healthcare provider. Refrain from sex until the infection clears and let your partner(s) know so they can get tested. [4]

Can I treat funiculitis at home?

Ice, rest with the pelvis elevated and scrotal support can ease symptoms, but treatment depends on the cause, so see a healthcare provider if you have any symptoms. Check with a provider before taking NSAIDs. [4]

Can funiculitis be prevented?

You can lower your risk by avoiding chemicals that may irritate the area, getting recommended vaccines, getting STI tests every three to six months if you are sexually active, practicing safe sex and washing your hands regularly. [4]

What are the symptoms of funiculitis?

Common symptoms include swelling and tenderness in the scrotum, pain when urinating, lower belly pain, and fever or chills. Sudden, severe testicle pain needs emergency care right away, because it can be testicular torsion.

Related Reading

Epididymitis: Symptoms, Causes, and Treatment explains inflammation of the tube behind the testicle, often seen with funiculitis.

Orchitis: Symptoms, Causes, Diagnosis, Treatment and Prevention Guide describes inflammation of one or both testicles and its causes.

Testicular Torsion: Symptoms, Causes, Diagnosis and Treatment — What You Need to Know explains the scrotal pain emergency that needs surgery within hours.

Chlamydia: Symptoms, Causes, Treatment, and How to Protect Yourself covers a common STI that can lead to spermatic cord inflammation.

References

1. Yam WL, Ng FC. Spermatic cord abscess: a rare complication of epididymo-orchitis, the diagnosis and management. BMJ Case Reports. 2014;2014:bcr2014205019. PMID 25096656. https://doi.org/10.1136/bcr-2014-205019

2. Hufstetler K, Llata E, Miele K, et al. Clinical updates in sexually transmitted infections, 2024. Journal of Women's Health. 2024;33(6):827-837. PMID 38770770. https://doi.org/10.1089/jwh.2024.0367

3. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports. 2021;70(4):1-187. PMID 34292926. https://doi.org/10.15585/mmwr.rr7004a1

4. Cleveland Clinic. Funiculitis. Cleveland Clinic. April 24, 2025. https://my.clevelandclinic.org/health/diseases/funiculitis

Medical disclaimer

This article was prepared for general information only and is not a substitute for professional medical advice.