Epididymitis

Epididymitis is inflammation of the epididymis, the coiled structure behind the testis that stores and transports sperm. Infection is a common cause. In sexually active people, Chlamydia trachomatis and Neisseria gonorrhoeae are frequent pathogens. Coliform organisms or Pseudomonas species become more likely after urologic procedures or in older men, particularly when urinary flow is impaired. Inflammation causes oedema and pressure in sensitive scrotal tissue. The usual picture is unilateral pain, tenderness, swelling, and erythema that builds over hours to days rather than striking suddenly. Fever or urinary and genital symptoms may be present, but their absence does not safely exclude infection. A patient with two days of increasing left-sided scrotal discomfort and swelling may fit epididymitis. That pattern becomes unsafe if the pain began abruptly, became severe within minutes, or is accompanied by vomiting. The first task is not to prove epididymitis; it is to protect the testis from a missed torsion.