How can I palpate the epididymis?

Palpation of the testis and epididymis is most easily performed in a standing position. With one hand the penis is lifted slightly and with the free hand the testicle can be palpated. It is important here to assess the testicles individually.

The epididymis is located on the upper pole of the testis and is easier to palpate from the back of the scrotum. As a rule, the epididymis feels slightly softer than the testicle itself. During the examination attention should be paid to pain, sensitivity to touch, accumulation of fluid and hardening.

Associated symptoms

Depending on the underlying cause, different symptoms can be accompanied by swelling of the epididymis. Spermatocele and tumors are usually characterized by a lack of symptoms, especially painlessness. On the other hand, inflammation can lead to redness, swelling and overheating of the scrotum.

The pain is mostly side dominant. Since in the majority of cases the inflammation originates in the urinary tract, patients often report pain when urinating and a residual urinary sensation. In addition, there is an increase in pain during sexual intercourse.

Depending on the triggering pathogen, systemic symptoms such as fatigue, fever or swelling of the lymph nodes may also occur. Sexually transmitted diseases are often accompanied by other symptoms. Chlamydia and gonorrhea lead to purulent discharge in the morning, while syphilis leads to the development of painless, nodular ulcers.

Treatment

The treatment of epididymal swelling can vary greatly depending on the underlying cause.Inflammations of the epididymis in the context of sexually transmitted diseases or classic urinary tract infections require antibiotic therapy. Depending on the pathogen, different preparations are used. For pain therapy, light painkillers such as ibuprofen or paracetamol are prescribed.

In the case of sexually transmitted diseases, the sexual partner must always be treated as well to avoid reinfection. In older patients with frequent urinary tract infections, the cause should be clarified. The diagnosis of a spermatocele is usually not a therapeutic indication, as it is a benign mass without symptoms. Tumors of the epididymis are in any case removed by surgical treatment and, depending on the stage of the tumor, are further treated.