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An 18-Year-Old Man Comes to the Office Due to 2

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An 18-year-old man comes to the office due to 2 days of right testicular pain.  The pain is constant and exacerbated by movement.  Vital signs are within normal limits.  On physical examination, there is swelling and tenderness to palpation localized only to the posterior and superior areas of the right testis.  The left testis is normal.  Cremasteric reflexes are intact bilaterally.  Urinalysis shows numerous leukocytes but no bacteria.  Which of the following factors most likely contributed to this patient's current condition?


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