The testes produce sperm and the epididymis stores sperm, and fertility can be greatly diminished if one place is damaged by tuberculosis. Tuberculosis of the epididymis is the most prevalent form of tuberculosis in the male genital organs. There are two main sources of tuberculosis: one is the tuberculosis bacillus that reaches the epididymis through the blood circulation; the other is the tuberculosis bacillus that travels down the urinary tract from the kidney and invades the epididymis through the prostate. The onset of the disease is slow and insidious, and may generally be palpable with hard nodules in the scrotum or with a slight feeling of swelling and pain. Most patients are often found incidentally during infertility tests, bathing, or routine physical examinations. Tuberculosis bacteria in the epididymis often spread directly to the testicles. Once the tuberculosis bacilli have invaded the testes, caseous changes, cavity formation and fibrosis occur, resulting in damage to the normal structure of the testes and impairment of the testes’ function of producing male hormones and sperm, leading to impotence and infertility. The early stage of testicular tuberculosis is often characterized by swollen testicles, vague pain or mild tenderness, which can be easily confused with orchitis. Subsequently, due to caseous necrotic lesions, cold abscesses are caused, which break down and form sinus tracts with constant flow of cold pus for a long time. The best time for treatment is often missed when the symptoms are obvious.