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Q&A
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Why do I feel pain in my epididymis?

Answered by: Dr Ranjith Ramasamy

Clinical Associate in Urology, New York-Presbyterian Hospital, Cornell University, USA

Q. I am a 23 years old male having problem in my right epididymis. Sometimes I feel pain in my epididymis and it becomes hard and little bit swollen. But I feel no pain while urinating and after ejaculation everything returns to normal. Please advise.

A.  Pain on one side of the epididymis can be caused by a variety of conditions. Since your pain is transient and is relieved with ejaculation, the most likely cause is spermatocoele. A spermatocoele is a cystic accumulation of sperm that contains fluid typically arising from the head of the epididymis. It is a common benign finding on routine physical examination and is usually smaller than 1 cm. The other causes of epididymal pain include varicocoele, inflammation, infection (including TB) and inguinal hernia. A good physical examination by a urologist and a scrotal ultrasound can help distinguish between these causes. If the ultrasound is not conclusive, a rare cause of the pain can be sexual arousal (orchialgia), which may occur after heavy petting in young males and is sometimes relieved by ejaculation.

A.  Pain on one side of the epididymis can be caused by a variety of conditions. Since your pain is transient and is relieved with ejaculation, the most likely cause is spermatocoele. A spermatocoele is a cystic accumulation of sperm that contains fluid typically arising from the head of the epididymis. It is a common benign finding on routine physical examination and is usually smaller than 1 cm. The other causes of epididymal pain include varicocoele, inflammation, infection (including TB) and inguinal hernia. A good physical examination by a urologist and a scrotal ultrasound can help distinguish between these causes. If the ultrasound is not conclusive, a rare cause of the pain can be sexual arousal (orchialgia), which may occur after heavy petting in young males and is sometimes relieved by ejaculation.

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