Unilateral: Epididymitis from chlamydia or gonorrhea almost always involves only one testicle. That testicle is not only painful, but enlarged and usually very tender. However, there are other possible causes. Most important is torsion, i.e. twisting of the testicle, and is most likely if pain onset is sudden. It needs emergency surgery, so if in doubt see a doctor immediately, even if it means an ER visit.
Answered 3/14/2016
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