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Why do I feel pain in my epididymis?

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.

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