Sudden onset of pain in the lower back, combined with unilateral pain, mainly affecting the left testicle, less often the entire scrotum – a common occurrence, especially during the cold winter months, is a cause for concern in many men. Most often, it subsides quickly and without seeking medical attention. Is this dangerous? What could be the reasons? The main cause of such pain is epididymitis – inflammation of the epididymis. The epididymis, also known as the epididymis, is a highly convoluted tube attached to the tip and back of the testicle. In this channel, the young spermatozoa accumulate and remain until full maturation. Affecting mainly men between the ages of 20 and 39, the condition is an inflammation of the convoluted tubule. The main cause is a bacterial infection after a sudden cold on the back or groin. The pain starts low, is felt below the belt and above the gluteal muscles and descends to the testicles. Most often, the condition is expressed only with temporary pain lasting up to 2-3 days. It can be unlocked during movement, as well as during prolonged stagnation and sexual activity. A slight swelling of the back of the testicle is present on palpation. If no other symptoms are present, the pain subsides and the immune system deals with the inflammation without the need for medication. With more acute pain, non-infectious epididymitis may require the use of anti-inflammatory drugs. In the presence of symptoms such as pain during urination, the presence of blood in the ejaculate, increased temperature and the development of orchitis – inflammation of the testicles, medical intervention is imperative to avoid more serious complications. Swelling of the epididymis is characteristic – it can double in size within 3-4 hours. NEWS_MORE_BOX These symptoms can be caused by sexually transmitted infections – Chlamydia trachomatis and Neisseria gonorrhoeae. When practicing unsafe anal sex, it is possible to get Escherichia coli into the urinary tract, and accordingly – to develop bacterial epididymitis. Cases of epididymitis caused by fungi of the genus Mycobacterium, some enteroviruses and adenoviruses, the mumps virus, mycoplasmas and mycobacteria are less common. Diagnosis by a urologist may include ultrasound to rule out testicular torsion, CT scan, or MRI when cysts, tumors, and fluid in the testicles are suspected. When acute epididymitis caused by sexually transmitted pathogens is diagnosed, treatment is carried out with azithromycin, ceftriaxone or tetracycline or doxycycline – it is important to warn sexual partners when such a diagnosis is made. Enteropathogenic bacteria (E. coli) are affected by fluoroquinolones – ofloxacin and levofloxacin.