Dear sir; madam, have a good day. I want your help for my case which I’ll provide you as follows: I am 48y old, on July 2009, I had attack of acute mild pain and discomfort at the back of my left testis as well as a strange feeling on the skin of the scrotum on the lift side, it felt as if a patch is attached to the skin at that area. Both of them (pain & discomfort) progressed gradually over time to become more annoying, and spread to the groin above and along the site of the spermatic cord on my lift side. At that time and up till now there were no discharge from the penis or fever or any change in urine, also prostatic culture was negative for any growth. I was negligent and I didn’t visit my doctor, and the pain and discomfort were worse over time and affected the right side as well. On March 2011, I was self-examining my lift testis when I had an attack of sudden, severe, shooting pain from the lower part of my lift testis along the course of the spermatic cord which alarmed me to visit my doctor. I went to andrologist who said, this is acute epididymitis and gave me tavanic 500 for 10 days. I did testicular ultrasonography which revealed hyperemia and varicocele on both sides but more on the lift side with normal epididymis . My condition did improve but not fully, so I took tavanic for 20 days + tinidazole 2gm once, with good but no full improvement, so I took ceftrioxone 1gm daily + doxycycline 100 bid for 2 weeks, I felt significant improvement after 12 hours and the original complaint had gone. However there is always dull pain and discomfort on my lift testis. I visited two andrology professors; one told me it was thrombophelbitis probably (since I had septic thrombophlebtis of my right saphenous vein after minor work on my teeth several years ago. Still I have bad teeth) he gave me alpha chemotrypsin shots + doxycycline 100 mg bid +daflon for 2 weeks, but my condition did not improve, the 2nd doctor found grade 2 voricocele and gave me also daflon + alpha chemotrypsin for 10 days, but it was the same until now. I do have dull aching and pain on my lift testis, especially when I work for long time. I wish to inform you that when I had saphenous vein problem it took a year or so for pain to go away fully and it was recurring. Now I do not know what was there to start with, epidydmitis , thromboplebitis or both Should I take Zithromax, tinidazole, tavanic, ciprofloxacin, ceftrixone alone or in combinations? Or what to do What was the possible diagnosis? I appreciate your opinion and help in advance Thank you very much