Epididymitis: Chronic Symptoms and Concerns Explained

Epididymitis with a mass?

About three years ago, after having sexual intercourse, my testicle became swollen and extremely painful.
At that time, my right testicle was completely swollen, and it hurt to touch it.
I also felt a hard lump below the other testicle.
There was blood in my ejaculate, which made me very anxious, so I went to the hospital.
I underwent a urinalysis and an ultrasound.
The doctor later diagnosed me with epididymitis.
After taking medication for a few days, I noticed the pain subsided, so I stopped taking the medication.
However, I still felt the lump below my right testicle.
When I returned for a follow-up appointment and reviewed the report, the doctor reassured me that it was just epididymitis, so I felt relieved, thinking it was merely inflammation.

However, after such a long time, I still feel something is off.
When I touch the lump, it hasn't increased in size, it doesn't hurt, and its surface doesn't seem irregular.
Could this lump possibly be a post-inflammatory change from the epididymitis, known as chronic epididymitis, since there have been no recurrences? Or could it be testicular cancer or a malignant tumor?

321, 20~29 year old female. Ask Date: 2018/06/16

Dr. Xu Wencang reply Urology

After inflammation, the lump does not resolve quickly, and there is currently no fever or pain.
Follow-up at the outpatient clinic is recommended.

Reply Date: 2018/06/16

More Info

Epididymitis, particularly when it becomes chronic, can lead to a variety of concerns and symptoms that may linger long after the initial infection has resolved. Your experience of acute pain and swelling in the right testicle, along with the presence of a hard lump, is not uncommon in cases of epididymitis. The inflammation can cause changes in the epididymis, which may result in a persistent lump or hardness even after the acute symptoms have subsided.

Understanding Chronic Epididymitis
Chronic epididymitis is defined as inflammation of the epididymis that lasts for more than six weeks. It can occur after an acute episode of epididymitis, which is often caused by bacterial infections, sexually transmitted infections, or other factors such as trauma or urinary tract infections. In your case, it seems that the acute episode was treated effectively, but the residual lump remains a concern.

Possible Causes of the Hard Lump
1. Post-Inflammatory Changes: After an episode of epididymitis, it is possible for scar tissue to form in the epididymis, leading to a hard lump. This is often benign and does not indicate a serious underlying condition.

2. Chronic Epididymitis: If the inflammation persists, it can lead to chronic symptoms. This may not always be associated with pain but can result in discomfort or a sensation of fullness.

3. Testicular Tumors: While the likelihood of a hard lump being a testicular cancer is relatively low, especially if it has not changed in size or character, it is still important to consider. Testicular cancer typically presents as a firm, painless mass, and it is crucial to rule this out through appropriate evaluation.

Recommendations for Management
1. Follow-Up with Your Urologist: Given your history and the persistent lump, it is advisable to have a follow-up appointment with a urologist. They may recommend imaging studies, such as an ultrasound, to assess the characteristics of the lump and rule out any malignancy.

2. Monitoring: If the lump has remained stable and is not causing any pain or discomfort, your doctor may suggest a watchful waiting approach. Regular follow-ups can help monitor any changes.

3. Consider Further Testing: If there are any changes in the lump, or if you develop new symptoms (such as pain, changes in urination, or systemic symptoms like fever), further testing may be warranted. This could include blood tests, imaging, or even a biopsy if there is significant concern.

4. Lifestyle and Support: Managing stress and maintaining a healthy lifestyle can also aid in recovery and overall well-being. If you have concerns about sexual health or function, discussing these with your healthcare provider can provide additional support.

Conclusion
In summary, while the hard lump you are feeling could be a remnant of your previous epididymitis, it is essential to have it evaluated to rule out any serious conditions. Regular follow-ups with your healthcare provider will ensure that any changes are monitored, and appropriate action can be taken if necessary. Remember, being proactive about your health is key, and addressing any concerns with your doctor will help you feel more secure about your condition.

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