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Generally, the most common cause of epididymitis is bacterial infection, often originating in urine, the prostate, or the ejaculatory duct.

 
Tuberculosis: Mycobacterium tuberculosis can present itself as epididymitis. Tuberculosis is a chronic infection of the lungs caused by the mycobacterium tuberculosis. The disease is spread through airborne droplets expelled from an infected individual’s mouth through coughing, sneezing, or spitting. Although it has become increasingly associated with immune suppression in AIDS-infected men, this form of epididymitis is more commonly found in areas where tuberculosis is still a public health problem. 
 
Vasectomy: Vasectomy is a surgical procedure for male sterilization and permanent birth control. During the procedure, the male vasa deferentia are severed and then sealed in a manner so as to prevent sperm from entering into the seminal stream and thereby prevent fertilization from occurring. Chronic scrotal pain is the most common post-vasectomy complication. Other causes of the pain include congestive epididymitis, pain from the nerve ending at the incision. 
 
Certain medications like heart rhythm drug amiodarone can cause epididymitis. Amiodarone is an antiarrhythmic agent used for various types of cardiac dysrhythmias, and ventricular andatrial. Amiodarone is sometimes responsible for epididymitis, a condition of the scrotum normally associated with bacterial infections but which can also occur as a non-bacterial inflammatory condition. Amiodarone accumulates in the head of the organ and can cause unilateral or bilateral inflammation. 
 
Certain diseases like Behcet’s disease also can cause epididymitis. Behcet’s disease is a rare immune-mediated small-vessel system that often presents with mucous membrane ulceration and ocular problems. It is an autoimmune condition that can cause to develop mouth and genital sores along with other symptoms. Behçet’s disease can cause male infertility, either as a result of the condition itself or of a side effect of concomitant medication such as colchicine, which is known to lower sperm count.
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