There is an acute form of Epididmytis however, the most common form seen in any urologist’s office is that of chronic epididimytis. In the acute form, the man develops a very intense swelling, redness and pain of one or both testicles over 1 or 2 days. It is often associated with burning and frequent urination, fevers and difficult urination which becomes a medical emergency at times requiring hospitalization.
With the much more common Chronic Epididimytis, the man complains of soreness of the testicle and scrotum that can last for days or weeks. It can also radiate to his lower belly. It is not usually associated with any significant swelling and is not usually caused by bacteria. For this reason, antibiotics do not provide any significant relief.
If on physical exam or patient self exam there is a nodule or area of hardening, it is not unreasonable to get an ultrasound to rule out a testicular tumor, thought this is not found frequently