Chronic/Acute Epididymitis

   Acute epididymitis is a clinical syndrome of inflammation, pain and swelling of the epididymis lasting less than 6 weeks. Chronic epididymitis involves long-standing pain without swelling. Epididymitis is usually caused by the spread of infection from the urethra. Infectious agents vary with the age of the patient. Organisms causing urethritis predominate in younger (<35 y/o) men while agents of bacteriuria secondary to obstructive urinary disease are typically seen in older men. In the acute setting, epididymitis must be clearly distinguished from testicular torsion. Chronic epididymitis is an occasionally sequela to the acute condition. Patients note a persistent though less intense pain in the scrotum that lacks the edema often seen with acute epididymitis. A long-standing inflammatory response can lead to fibrosis and the formation of a palpable mass in the epididymis. A course of antibiotics are usually prescribed for either condition.