Symptoms of Epididymitis
Jun 20, 2022
Source: Cainiu Health
Dr. Luo Yong
Introduction
Symptoms of acute epididymitis: In most cases, patients with acute epididymitis experience sudden high fever, scrotal swelling and pain, enlargement of the epididymis with a sensation of heaviness or dragging, and marked tenderness. Referred pain may also occur in the lower abdomen and inguinal region.
Symptoms of chronic epididymitis: Patients commonly report persistent or intermittent pain on the affected side of the scrotum; the pain is typically dull and accompanied by a sensation of fullness or heaviness. Pain may also radiate to the inguinal (groin) region or lower abdomen.
Epididymitis refers to inflammation of the epididymis, which occurs when pathogenic bacteria—such as *Escherichia coli*, *Staphylococcus*, and *Streptococcus*—enter the vas deferens and ascend retrograde into the epididymis, typically during periods of diminished host immunity. It predominantly affects young and middle-aged men. Clinical presentations are generally categorized into acute and chronic epididymitis.
① Symptoms of Acute Epididymitis
In most cases, patients with acute epididymitis present with sudden high fever and elevated white blood cell count on routine blood tests. Affected-side scrotal swelling and pain occur, accompanied by epididymal enlargement, a sensation of heaviness or dragging, and marked tenderness. Referred pain may also be felt in the lower abdomen and inguinal region. When inflammation spreads extensively, both the epididymis and testis become swollen, with indistinct boundaries upon palpation—a condition termed epididymo-orchitis.
② Symptoms of Chronic Epididymitis
Scrotal pain is the hallmark symptom of chronic epididymitis, often manifesting as persistent or intermittent unilateral scrotal discomfort, usually described as dull or aching, with associated sensations of fullness or heaviness. Pain may radiate to the lower abdomen and ipsilateral inguinal region; some patients report pain in the groin or lower abdomen. Ipsilateral vas deferens thickening may also be observed. Notably, chronic epididymitis can lead to hydrocele, although this is not universally present and typically occurs secondarily.
