Epididymitis is acute and chronic inflammation triggered by a bacterial infection in the epididymis, triggered mainly by urinary tract infection and retrograde infection to the epididymis and testicles. 

Epididymitis can destroy the structure of the epididymis, causing adhesions and blockages to form within it, affecting the epididymis' function of storing, maturing, and transporting sperm. Therefore, epididymitis may lead to male infertility if it is severe. 

So, does unilateral epididymitis affect male fertility?

On the one hand, epididymitis on one side does not affect overall fertility. Epididymis is a part of the male sperm output tract and a place for sperm maturation. The vas deferens on both sides of the body are not connected. When one side of epididymitis is infected, it mainly affects the smoothness of the vas deferens on the same side, generally does not affect the sperm discharge on the opposite side, and does not affect fertility.

On the other hand, epididymitis, affected on one side, may impact fertility. Inflammation on one side of the epididymis will inevitably lead to a decrease in the overall quality of semen, and localized inflammation will also lead to sperm deformities, etc., and the quality of the embryo will be reduced. In addition, inflammation on one side may lead to problems on the other. The testicles and epididymis on both sides are neighbors, and blood vessels connect the two. When inflammation occurs on one side, its poison and metabolites may affect the other.

Therefore, when suffering from epididymitis on one side, it is not only important to actively seek treatment but also advisable to temporarily avoid preparing for pregnancy for the time being. It would be better to reconsider the issue of childbearing after recovery.

So, how do men treat epididymitis to protect their fertility?

1. Patients with acute epididymitis can rest in bed. Applying scrotal support can reduce symptoms; homemade larger scrotal support with cotton pads will be more comfortable. Patients with severe pain can use painkillers and localized heat therapy to relieve symptoms and promote the inflammation to subside. 

Patients with acute epididymitis can choose drugs sensitive to bacteria, usually given intravenously for 1-2 weeks, followed by oral antimicrobial medications for 2-4 weeks to prevent the transition to chronic inflammation. If the situation is serious, systemic anti-infective treatment must be carried out, along with the spermatic cord closed injection treatment; the effect is better. 

However, some patients do not pay attention to it or terminate the treatment when the symptoms are relieved by the treatment. Incomplete treatment leads to the formation of localized inflammatory nodules in the epididymis, and the symptoms are prolonged and recurring.

2. For patients with chronic epididymitis or localized inflammatory nodule formation, treatment should focus on protecting testicular and epididymal functions while controlling the infection. Through the TCM treatment principle of activating blood circulation and removing stagnation, softening hard lumps, and dispelling nodes, oral treatment with Diuretic and Anti-inflammatory Pill can minimize the occurrence of obstructive spermatosis and protect male fertility from being implicated.

If antibiotics are ineffective in treating acute epididymitis and testicular ischemia is suspected, the epididymis should be incised and decompressed, with multiple incisions of the epididymal dirty layer of the sheath longitudinally or transversely, but avoiding injury to the epididymal duct.

In summary, the treatment for epididymitis should be symptomatic according to the cause. Even if it is unilateral epididymitis, it should cause men to pay great attention to it. Otherwise, it may affect fertility.

Patients under treatment should develop healthy living habits and good private hygiene, especially for men with too long prepuce. Pay attention to sexual abstinence, do not indulge in sex, do not wear tight pants to prevent the testicular temperature from becoming high, affecting sperm production, and appropriate exercise to improve their resistance and immunity. 

The most important thing is that once the uncomfortable symptoms appear, the patient should go to the hospital in time to avoid delaying the condition.

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