Firstly let me congratulate you for the successful outcome of the varicocelectomy. Varicocelectomy per-se, is not expected to cause an epididymitis.
In clinical practice,one tends to classify epididymitis into
- acute and
- chronic types.
The pathogenesis of epididymitis in general, and chroinc epididymitis in particular is poorly understood. Although generally believed to be an infective process, a sizable number of these patients show no demonstrable evidence of infection.
There is no universally accepted definition for "chronic" epididymitis. Its incidence and prevalence have not been well studied.It remains a "common and important, but neglected, urologic diagnosis.Some workers have recommended that it should be defined as "symptoms of discomfort and/or pain at least 3 months in duration in the scrotum, testicle, or epididymis localized to one or each epididymis on clinical examination" (Rev Urol. 2003 Fall; 5(4): 209–215.).
An epididymitis (inflammation of the epididymis), generally regarded to be due to a retrograde entry of organisms via the vas deferens. This affects the tail of the epididymis first,then its body and then its head.The swelling may persist for varying lengths of time despite adequate treatment.
Varicocelectomy is not an accepted cause of epididymitis.
You have not indicated whether the ultrasound report indicated an "acute" or a "chronic" epididymitis. In your case,it is important first to determine whether your symptoms are indeed as a result of epididymitis.
Epididymectomy certainly feasible and in several studies it is shown to be beneficial in relieving the symptoms of 'chronic' epididymitis.
In uncomplicated acute epididymitis, management is in most cases, non-operative.
I feel that you should quit worrying excessively and let your doctor deal with it based on the clinical findings and the results of the various tests.
MB BS, MS, FRCS(Edinburgh)