Here is some information that may help you all. There are a number of causes for epididimytis. First of all, it is an infection. STDs can account for it as well as any procedure that can introduce bacteria into the scrotum such as a vasectomy. It can also be caused when heavy lifting, during which, some urine is forced back into the epididymis causing a chemical reaction and infection. The epididymis is located behind the testicle with a larger portion of it near the top. When it inflames, it can seem like a large swollen mass on top of the testicle and even bulge out in odd directions like towards the other side of the scrotum.
Treatment is usually antibiotics but as this region of the body is isolated very carefully to protect the sperm, it is difficult to get antibiotics into the region. This means that it may take higher doses or a longer time. Also, antibiotics target a specific spectrum of bacteria. In my case, it would only respond to a cocktail of two antibiotics (Cipro plus Augmentin). One or the other didn't do it. If you are feverish, chills and have aches you probably still have the infection. Once the infection is cleared up, it can take weeks or longer for all the swelling to subside since again it is difficult to get fluids in and out of that region. Ibuprofen helped reduce the swelling. My dosage was 600mg 4x/day which seems rather high to me so check with the docs first for sure.
My infection has reoccurred twice now and the current theory is that a single course (about 10 days) of the antibiotic was not enough to kill all the bacteria in the region. It would kill enough to the point the body can keep infection in check but as soon as another factor was introduced (like strenuous martial arts in my case) some swelling or constriction of blood flow was just enough to let the infection grab hold again.
The current treatment in my case is longer term antibiotics until all evidence of swelling is gone.
Be careful because the infection can lead to an abscess and that is best removed surgically since again it is hard to remove fluids (and by products of fighting infection) from that region. The main risk is the abscess intertwines with the testicular blood vessels making it impossible to remove without removing the testicle.
My time line was like this: Swelling due to physical activity within about 12 hours. Increased swelling, fever, chills within 48 hours (no treatment except ibuprofen and ice during this time). 2 days of Augmentin with no improvement and 3 additional days of Cipro Augmentin before fever was gone. 1 week on both antibiotics before the swelling started noticeably reducing. 2 weeks total now and while half the size it was at the peak, the epididymis is still enlarged and hard. We are keeping our fingers crossed that it didn't/doesn't abscess but it appears to be progressing well now.