A 19-Year-Old Man Comes to the Physician with Right-Sided, Dull

A 19-year-old man comes to the physician with right-sided, dull, throbbing scrotal pain for 12 hours. He has not had urethral discharge. He is sexually active with one female partner. Vital signs are within normal limits. Physical examination shows a tender right testicle; lifting it provides relief. The penis appears normal, with no discharge at the meatus. Urinalysis shows numerous leukocytes but no bacteria.  Which of the following factors most likely contributed to this patient's current condition?

A) Inadequate childhood vaccination
B) Increased gonadal venous pressure
C) Lack of normal testicular fixation
D) Unprotected sexual intercourse
E) Urethral colonization by coliforms

Correct Answer:

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