Epididymis pain
definition
The epididymis is located together with the testicle in the scrotum and represents a connection between the testicle and the spermatic duct. If there is pain in the epididymis, there can be a variety of reasons for this.
Often the patient cannot name the epididymis as the pain location, but rather the groin region or the scrotum as the pain point.
Which diseases can cause epididymal pain?
The most common and therefore most important disease that can lead to epididymal pain is inflammation of the epididymis. Bacteria, and in rarer cases viruses, fungi or parasites, migrate through the urethra and the vas deferens to the epididymis and cause an infection there.
Another cause of epididymal pain can be a varicocele. The sperm accumulate in the epididymis and vas deferens as a result of an obstruction in the vas deferens drainage. Such obstructions to the outflow can arise deliberately through a severing of the vas deferens for contraception or through diseases such as cystic fibrosis.
In addition to a build-up of sperm, a build-up of blood or fluid in this area can also cause pain. They are often the result of an inflammation, injury, or swelling in the pelvis that slows blood or fluid outflow.
Another cause of epididymal pain can be testicular torsion. Nevenas and vessels are severely squeezed and damaged in the process. Testicular torsion is therefore an emergency situation that should be treated immediately.
Autoimmune diseases and cancers in this part of the body can also cause pain on the epididymis, which are less common causes.
You may also be interested in this topic: Chronic epididymis
Epididymitis
Epididymitis is probably the most important cause of epididymal pain. Bacteria, rarely viruses, fungi or parasites, often migrate through the urethra and the vas deferens into the epididymis. Before the epididymis pain 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 associated with a urinary tract infection, which is usually caused by intestinal germs.
Another group of infectious agents are sexually transmitted diseases that often affect the spermatic duct and epididymis in men. In this case, the infection should be stopped with an antibiotic. In the worst case, these germs, such as chlamydia or gonococci, lead to sterility in men.
Of course, an injury or an autoimmune disease can also cause epididymitis. The underlying disease should be identified and treated.
Otherwise, drugs such as amiodarone can also trigger such inflammation. In some cases there is no apparent cause.
All these epididymitis have in common that they are associated with general signs of infection, such as swelling and overheating, and the so-called "Prehn sign" is positive. The pain in the epididymis subsides after the testicle is lifted.
Read here how you can recognize epididymitis: I recognize epididymitis from these symptoms
Inflammation of the testicles
Due to its location, testicular inflammation is observed less often than inflammation of the epididymis, the vas deferens or the urethra. Often, however, no precise distinction can be made between testicular and epididymitis due to the symptoms. That means in both cases there is pain in the area of the testicles and epididymis.
The testicular inflammation occurs either through a continuation of the epididymis or in isolation.
In most isolated cases, the infection is caused by the mumps virus. Otherwise, testicular inflammation is handled and treated identically to epididymitis.
rheumatism
The various rheumatic diseases belong to the autoimmune diseases. As a concomitant symptom, these can also lead to epididymitis and therefore pain in the epididymis.
In this case, a precise diagnosis should reveal the rheumatic disease and lead to therapy for it. The pain in the epididymis is combated by treating the underlying disease.
vasectomy
The vasectomy is a type of contraception. The man's two sperm ducts are surgically cut. The goal is that the vas deferens are no longer continuous and scarred at the interface. As a result, sperm can no longer get from the epididymis to the prostate and via the urethra to the outside.
In rare cases there is a feeling of pressure and pain after a vasectomy in the area of the epididymis and the vas deferens due to the fact that the sperm are now accumulated. As a rule, the pain soon subsides or does not arise at all. However, if this lasts longer or is felt to be particularly painful, a doctor should clarify whether an infection occurred during the operation. An antibiotic can help in this case.
What can I do about epididymal pain?
If there is pain in the epididymis, simply elevating the testicle can relieve the pain. In addition, the scrotum should be cooled and the patient asked to rest in bed. In addition, pain medication that also treats inflammation should be given. Such drugs are, for example, ibuprofen or diclofenac.
Depending on the possibly causing germ, an antibiotic should be given to stop the infection and thus the pain.
If a testicular twist is suspected, which is particularly painful, a twisting back of the testicle can be attempted. The testicle should be carefully turned outwards. In any case, however, a doctor should be contacted as testicular torsion is an urgent emergency. Pain in the epididymis should always be examined by a doctor and, if necessary, treated.
Duration of epididymis pain
The duration of epididymal pain depends entirely on its cause and the success of the treatment. In most cases the symptoms resolve themselves completely after a few days or after therapy.
In some rarer cases, however, the pain comes back soon or doesn't completely go away over weeks. Close doctor-patient contact should be established here in order to intensify the treatment and to initiate further steps against pain.
You can also read about the Duration of epididymitis
Course of epididymis pain
As a rule, the diseases that are behind epididymal pain go well and heal completely within a few days to weeks.
In some rare cases, however, permanent damage, such as sterility or testicular size reduction, can occur.
The sterility can be triggered by a persistent illness with sexually transmitted germs, such as the chlamydia and gonococci, or a twisting of the testicles.
The shrinkage of the testicles may result from a mumps disease of the testicles.
For this reason and in order to avert further dangerous courses, a doctor should be contacted with any type of epididymis.
Accompanying symptoms with epididymal pain
Pain in the epididymis is often associated with reddening, overheating and swelling at this point and indicate inflammation. In many cases such an infection can also cause the regional lymph nodes in the groin to be painfully enlarged.
If the infection continues to spread, painful urination and fever may also occur.
Otherwise, the symptoms of the actual underlying disease that caused the pain in the epididymis also appear as accompanying symptoms.
Joint pain and stiffness can occur in the context of a rheumatic disease, which can cause epididymal pain.
A bilateral swelling of the cheeks and chewing pain can occur together with a mumps infection, which can cause testicular inflammation in young men and thus occur together with pain in the epididymis.
Epididymal pain when touched
Sensitivity to touch on the epididymis and the associated pain, in addition to the aforementioned epididymitis and injuries, can also be infections of the skin of the scrotum.
Ingrown hair roots are easily inflamed and cause severe pain, especially in a pain-sensitive area such as the scrotum.
Otherwise, in the event of such severe touch pain, twisting the testicles or other irritation of the supplying nerves should also be considered.
Pain in the testicle area should always be clarified and even in the case of an ingrown hair follicle requires therapy.
Epididymal pain after ejaculation
Pain in the epididymis can occur after ejaculation and is usually not pathological. This leads to a vascular spasm of the vessels leading away, so that there is a larger amount of blood in the penis and testicles during arousal than in the non-aroused state. After ejaculation, these vessels usually widen again so that the blood flows out.
In some cases, the widening is not immediate and the blood filling persists and can be painful.
This pain rarely lasts for a few hours and should then be examined by a doctor for other causes that are obstructing the drainage.
