Does orchitis for more than a month lead to hydrocele?

Patient's question:

Epididymitis has been going on for over a month, which can lead to hydrocele. About a month and a half ago, I had chronic epididymitis. At that time, the epididymis was swollen, and the scrotum felt heavy. It was accompanied by a dull pain, and at its worst, it interfered with walking. During this period, an ultrasound showed swelling of the epididymal tail and dilatation of the epididymal ducts. I took various antibiotics for a considerable amount of time. About a week ago, the condition suddenly improved. The scrotum no longer felt heavy, although there was still a lump in the epididymis, it hardly interfered and was almost imperceptible. The pain also almost disappeared, though occasionally there would be a slight soreness. So, I stopped taking the medication a week later. However, the other day when the weather was cold, I suddenly felt that my left testicle was a bit heavy and accompanied by intermittent sharp pain. Although it wasn't severe, there wasn't much pain these past two days, but the scrotum felt slightly heavy. At the same time, I noticed that the skin at the bottom of my left scrotum

Doctor's answer:

Epididymitis generally does not cause hydrocele, even if there is a small amount of fluid accumulation, it will not lead to excessive curvature. It is possible that the inflammation has not been properly controlled or is accompanied by varicocele. Avoid strenuous exercise, activities that increase abdominal pressure, and maintain good hygiene of the external genitalia. Refrain from sexual intercourse, take anti-inflammatory medication to control the inflammation, and undergo a color Doppler ultrasound examination at the hospital to confirm whether it is varicocele or hydrocele, so as to determine the severity and receive timely treatment. During treatment, medication should be used according to the symptoms. Additionally, patients should avoid prolonged sitting or riding and pay more attention to personal hygiene.