A painful extra testicular mass might well be epididymitis. So like we talked about in the testicle with orchitis, which is swelling and infection of the testicle itself, very often, this begins as epididymitis. So the epididymis, again, behind the testicle becomes acutely inflamed, very uncomfortable and swollen. Typically the inflammation is related to a bacterial infection and management includes the use of an antibiotic, but also just like orchitis it's best to elevate the scrotum, usually with tight fitting underwear or a jock strap. Apply ice initially, and then heat and use anti-inflammatories. This management results in successful treatment of epididymitis in most cases.