Hi,Dear,Thanks for your query to HCM. Dear I read facts of your query and reviewed it in context to your query health issues. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is- Knot Could be Hydatid Cyst of Morgagni-which is not to be worried. Vit D and B deficiency is just accompanied finding and needed correction and hence treated. The 3 weeks review- is mostly advised, as Your Urologist wants to take it one by and one to rule out the other causes- like Epididymitis ,as the knot is painful with tight jeans/ or it could be from Congested Testes with Varicocele. Epididymal Inflmmation with fibrosis in left testes with Calcification could be the cause of this knot. All this needs to be worked out.And for this he is taking a comforting way out in stages and not advising at one go, which could reduce the compliance from You and would defeat the whole intention of curing You at the end.Just be free with your doctor and express your anxiety and worries. Give him free hand to expedite the process of your treatment, by giving him your readiness for the budgets for this disease. Could be from STD with epididymitis which needs further treatment. Do s Suggested- Check by LCr testing of the Spermatocele aspirate and the blood and confirm if Chlamydica /Gonorrhea is still active . Consult Urologist who would be the right person to treat your chronic and complicated case. The Antibiotic Cover with Doxycycline/ and or Azithromycin x 2-6 weeks with Motrin 400 x 2 times a day would reduce the swelling. If not relieved with antibiotic and drug cover, Surgical Excision of this Painful knot under antibiotic cover - is the only remedy to prevent its recurrence and extention of the disease to other epididymus. Tab Serropetidase- 2 x 3 times a day x 2-6 weeks, would recoup the swelling in postop periods. So looking in to the sensitive complaint of yours,I would suggest you to rule out other causes of such a complaints by Consulting and investigating with Urologist and Urosurgeon doctor. It would be prudent to have physical Check from Consulting Urologist to start with/ first- before planning further investigations and treatment for it. Other causes need to be ruled out in any case. Constant followup for long term to fix the chronic epididymitis and accompanied prostatitis would give you long remissions in time to come and would depend on meticulous followup treatment of your chronic problems. Just don t worry and be patient and co-operate with your doctors,till you verify with your attending doctors. Need to Check with Consulting Urologist and UroSurgeon- if need be, if things don t recover. -Other causes need to be verified with your family GP /Consulting Urologist / Surgeon -Specialist doctors, as the facts may be different what you submitted. -For this Second opinion with Urologist / UroSurgeon- specialist-is needed who would do proper investigation after proper physical assessment to resolve your health issues. -for early recovery-please follow above do s which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS