A 61-year-old man presents with tenderness along the posterolateral aspect of his left testicle, which has gradually increased over the past 3 days. He reports intermittent vaginal intercourse only with his wife. Their last sexual activity occurred 8 days prior. On further questioning, he notes a significant increase in urinary frequency, reduced urinary stream, and nocturia over the past 6 months. He denies fever, chills, dysuria, hematuria, or other systemic symptoms. He has not had any recent medical procedures and does not recall recent trauma. He has no other medical problems and takes no medications. At this initial visit, a presumptive diagnosis of acute epididymitis is made.