Diagnosis
In addition to a detailed medical history (anamnesis), a thorough physical examination is crucial for the diagnosis of spermatic cord pain. For example, possible primary inflammation of the prostate or testicles can already be detected by an enlargement and painfulness due to pressure of the organ. Furthermore, differential diagnoses such as a hernia can be excluded.
Depending on the clinical suspicion, the physical examination is followed by blood and urine tests for inflammation parameters and bacteria.The pathogen diagnostics is complemented by the performance of a smear test. If the findings are unclear, an ultrasound examination is then carried out first, which allows an assessment of the affected structures. In individual cases, further diagnostic tools such as a CT, MRI or urological examination may be necessary.
Accompanying symptoms
Depending on the underlying cause, different symptoms can occur with pain in the spermatic duct. In the frequent case of inflammation, those affected usually report severe pain when urinating and during sexual intercourse. They also report an increased urge to urinate.
Depending on the pathogen and the primary focus of inflammation, a whitish-yellow discharge may occur. If the inflammation originates in the testicles, they are usually palpable with an enlarged palpation and clearly sensitive to pressure. Pronounced inflammation can be accompanied by a general feeling of illness and fever.
A similar clinical picture also occurs in the presence of abscesses. There are several causes that can lead to a blocked sperm duct and, in addition to pain, are associated with azoospermia, i.e. the absence of sperm in the ejaculate. These include inflammation, which, if it persists for a long time or is inadequately treated, can lead to adhesions and ultimately to a blockage of the spermatic duct.
Furthermore, a rarely occurring stone disease can also lead to a blockage of the duct. The formation of cysts, which usually develop in the prostate, can also lead to these symptoms. A swelling of the vas deferens with pain sensation is in most cases due to inflammatory processes.
In addition, a blockage of the spermatic duct or constrictions that occur in the course of the disease may also be a possible cause. The latter can occur, for example, in the context of benign prostate hyperplasia (benign prostate enlargement) or a tumorous event, which leads to a backlog of seminal fluid and ultimately to swelling. Tumors of the vas deferens itself, so-called vas deferens sarcomas, may also cause swelling, but they are rare and can be ruled out by performing a sonography. Further interesting information on this topic can be found here: Vas deferens swollen – What is behind it?