You could have noninfectious epididymitis. It is generally a chronic condition. It can be precipitated by trauma, autoimmune disease, or vasculitis. However, no etiology is found in many cases. Idiopathic noninfectious epididymitis is thought to occur due to reflux of urine through the ejaculatory ducts and vas deferens into the epididymis, producing a "chemical" inflammation with resultant swelling, causing ductal obstruction. Idiopathic noninfectious epididymitis can occur, however, even in men who have had a previous vasectomy. Typical inciting factors include prolonged periods of sitting (eg, long plane or car travel, sedentary desk jobs) or vigorous exercise (eg, heavy lifting).
Unlike patients with infectious epididymitis, patients with noninfectious epididymitis have less epididymal inflammation (pain, swelling). The diagnosis is usually made after the exclusion of other etiologies, particularly infectious epididymitis. No further evaluation is necessary for noninfectious epididymitis.
Treatment of noninfectious epididymitis is conservative, including scrotal elevation, rest from athletic activity, warm baths, and NSAIDs.