• Painful scrotal swelling (testes enlarged)
• A testicular lump
• A tender, swollen testicle on affected side
• A tender, swollen groin area on affected side
• Testicle pain aggravated by bowel movement
• A fever
• Discharge from urethra (the opening at the end of the penis)
• Pain with urination
• Pain with intercourse or ejaculation
• Blood in the semen
• Groin pain

Physical examination shows a red, tender, and sometimes swollen mass on the affected hemi-scrotum. Tenderness can usually be localized to a small area of the testicle where the epididymitis is attached.

Enlarged lymph nodes in the groin area (inguinal nodes) may be present. There may be a discharge from penis. A rectal examination may reveal an enlarged or tender prostate.

These tests may be performed:

• A urinalysis and culture (the provider may request several specimens including: initial stream, mid-stream, and after a prostate massage).
• Tests to screen for Chlamydia and gonorrhea (urethral smear).
• CBC.
• Doppler ultrasound (to rule out testicular torsion). One may see a hypoechoic region on the affected side as well as increased blood flow. It may also identify scrotal abcess.
• Testicular scan (Nuclear medicine scan) may also be obtained to rule out torsion. In case of the epididymitis, increased blood flow is also demonstrated.