Definition
The epididymis is located together with the testis in the scrotum and represents a connection between the testis and the vas deferens. If there is pain in the epididymis, there can be a variety of reasons for this. Often the patient cannot name exactly the epididymis as the location of pain, but rather the groin region or the scrotum as the site of pain.
Which diseases can cause pain in the epididymis?
The most common and therefore most important disease that can lead to epididymal pain is the inflammation of the epididymis. Bacteria, in rare cases also viruses, fungi or parasites, migrate via the urethra and via the seminal duct into the epididymis and cause an infection there. Another cause of pain in the epididymis can be a so-called varicocele.
In this case, the sperm accumulate in the epididymis and the vas deferens as a result of an obstruction in the vas deferens. Such obstructions can be caused intentionally by a severing of the spermatic duct for contraception or by diseases such as cystic fibrosis. In addition to a build-up of sperm, blood congestion or fluid accumulation in this area can also cause pain.
They are often the result of an inflammation, injury or swelling in the pelvis, which slows down the flow of blood or fluid. Another cause of pain in the epididymis can also be testicular torsion. In this case the nerves and vessels are severely squeezed and damaged. A testicular torsion is therefore an emergency situation which should be treated immediately. As rather rare causes also autoimmune diseases and cancer in this part of the body can cause pain in the epididymis.
Epididymitis
Epididymitis is probably the most important cause of pain in the epididymis. Bacteria, rarely also viruses, fungi or parasites often migrate via the urethra and the seminal duct into the epididymis. Before the pain on the epididymis appears, patients often feel a burning sensation when urinating or pain in the spermatic duct in the groin.
The inflammation of the epididymis is therefore often accompanied by a urinary tract infection, which is usually caused by intestinal germs. Another group of infectious agents are sexually transmitted diseases, which often affect the spermatic duct and the epididymis in men. In this case, the infection should be stopped with an antibiotic.
In the worst case, these germs, such as Chlamydia or Gonococcus, can lead to male sterility. Of course, an injury or an autoimmune disease can also be the cause of epididymitis. The underlying disease should be recognized and treated.
Otherwise, drugs such as amiodarone can also trigger such an inflammation. In some cases, no cause can be identified. What all these epididymitis have in common is that they are accompanied by general signs of infection, such as swelling and overheating, and the so-called “Prehn’s sign” is positive. The pain in the epididymis subsides after the testicle is lifted.
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