Epididymitis or inflammation of the epididymis is commonly painful, especially in acute epididymitis. Painless epididymitis is most commonly caused by tuberculosis of the epididymis.
Painless epididymitis is usually a type of chronic epididymitis and if there is suspicion of this condition, we would have to rule out tuberculosis of the urinary tract, also known as GUTB (genitourinary tuberculosis).
Untreated GUTB can have serious repercussions eg stritures or narrowing of the ureters and potential damage to the kidneys.