Symptoms of Epididymitis
Epididymitis refers to inflammation of the epididymis that occurs when the body’s immune defenses are compromised, allowing pathogenic bacteria—such as Escherichia coli, Staphylococcus, and Streptococcus—to enter the vas deferens and travel retrograde into the epididymis. It predominantly affects young and middle-aged men. Clinically, epididymitis is generally categorized into two types: acute and chronic.
① Symptoms of Acute Epididymitis
In most cases, patients with acute epididymitis experience sudden high fever, accompanied by elevated white blood cell counts on routine blood tests. The affected side of the scrotum becomes swollen and painful; the epididymis enlarges, producing a sensation of heaviness or dragging, and exhibits marked tenderness upon palpation. Referred pain may also occur in the lower abdomen and inguinal region. When inflammation spreads extensively, both the epididymis and testicle become swollen, and their anatomical boundaries become indistinct on physical examination—a condition termed epididymo-orchitis.

② Symptoms of Chronic Epididymitis
Persistent or intermittent scrotal pain on the affected side is the hallmark symptom of chronic epididymitis. This pain is typically dull and accompanied by a sensation of fullness or dragging. Pain may radiate to the lower abdomen and ipsilateral inguinal region, and patients may also report discomfort or pain in the upper thigh or lower abdomen. Ipsilateral vas deferens thickening may also be observed. Importantly, chronic epididymitis can lead to hydrocele formation—though this is not universally present and usually occurs secondarily.