Chronic epididymitis is a clinical diagnosis based on chronic epididymal pain lasting for at least three months. It is a common, possibly the most common, cause of scrotal pain.
One study found the median age at presentation is 46-49 years with an average duration of symptoms prior to presentation of ~5 years .
Patients present with chronic point tenderness of their epididymis +/- a palpable mass or swelling .
One classification of chronic epididymis is :
- inflammatory chronic epididymitis: mass/swelling present
- obstructive chronic epididymitis
- post-vasectomy pain syndrome
- chronic epidymyalgia: mass/swelling absent; cause unknown
Treatment and prognosis
Initial treatment consists of a trial of antibiotics as well as scrotal support, anti-inflammatories and analgesia including nerve blocks. Chronic epididymitis is generally considered "self-limited" albeit with a chronic course; refractory cases may require surgical resection of the epididymis .