2023-10-30 19:20:28
Anatomical definition of the epididymis
According to the work of “Larousse Médical” (source 1), “the epididymis (editor’s note: two in number) is a cylindrical organ.”
Where is the epididymis located in men?
The epididymis and testicle, surrounded by a membrane called the tunica vaginalis, are cheld in the scrotum. It extends laterally on the testicle, following the efferent cones (kind of small tubes emerging from the testicle) and extending through the vas deferens, or spermatic duct, which opens into the seminal vesicle and the prostate.
In composition
It is made up of a very long microscopic channel, coiled on itself, and is made up of three parts:
- The head of the epididymis which originates on the upper part of the testicle.
- The body of the epididymis which is the intermediate part extending on the dorsal surface of the testicle.
- The tail of the epididymis which constitutes the last part extending through the vas deferens.
Points d’attache
Each epididymis is connected to the testicle using the superior and inferior epididymal ligaments.
Protection
The epididymis and the testicle are protected from shock by the scrotum.
The epididymis, what is its role?
Place of sperm maturation
The epididymis is a bit like the “place” of finishes where the spermatozoa complete their maturation, particularly mobility with the flagellum. Dr Antoine Faix, urologist.
“This is what we call “capacitation” (editor’s note: process undergone by the sperm to be able to penetrate the egg to fertilize it).”
Sperm storage and tracking
Sperm are mainly stored in the tail of the epididymis but also in the body. Contractions of the muscular wall of the epididymis will transport the sperm to the vas deferens.
Why does my epididymis hurt? Associated diseases
The epididymis can be the site of numerous conditions:
- The most common causes of epididymitis are bacteria: “In men under 35, most cases are due to sexually transmitted germs, notably Neisseria gonorrhoeae or Chlamydia trachomatis. The infection can start with urethritis. In men over 35 years of age, most cases are due to Gram-negative coliform bacilli and also appear in the presence of urological abnormalities, an indwelling catheter or recent urological procedure” recalls the Manuel website MSD (source 2).
- Epididymal agenesis (incomplete development of the epididymis), congenital, which can lead to sterility when it concerns both epididymis.
- Inflammation of the epididymis, or epididymitis: “It is often associated with inflammation of the testicle and then becomes epididymal orchiepididymitis. When both epididymis are affected, there can be obstruction of the epididymal canals leading to sterility” adds Dr Antoine Faix.
- The epididymis cyst: it appears in the form of a nodule filled with fluid. “It only requires surgical removal if it is large or bothersome and has no impact on fertility,” reassures the urologist.
- Testicular cancer: malignant tumors can develop in the testicle and invade the epididymis. These tumors can remain silent for a long time without causing any particular pain.
What are the associated symptoms?
“The man complains of having pain in the testicles or/and of having a feeling of heaviness when playing sports or during sexual intercourse. He labels this discomfort as the testicles without necessarily knowing that it affects the epididymis. ” explains Dr Antoine Faix.
How do you know if you have an epididymal cyst?
“In general, it is quite asymptomatic. It will be advisable to consult if discomfort and a lump appear” explains the urologist.
What medical diagnosis in case of epididymis problem?
First, a clinical examination can be carried out to assess the patient’s symptoms. Palpation can be done to examine the respective epididymis and differentiate them from a testicular problem. If necessary, an ultrasound, a urine exam, possibly a semen exam as well as blood tests can be performed to confirm or complete a diagnosis.
A direct link with infertility
“By examining more or less young men who are unable to have children, we can see through an examination, the spermogram”, that sperm are sometimes missing, sometimes in connection with a partial absence or total epididymides, called epididymo-deferential agenesis” notes Dr Antoine Faix. The only solution is then to operate to surgically seek the spermatozoa in the testicles or on the head of the epididymides for freezing and then proceed with fertilization in vitro.
Possible treatments
Drug treatments
“Depending on the associated pathology, certain medications may be prescribed such as antibiotics or analgesics, particularly in the case of bacterial epididymitis” indicates Dr Antoine Faix.
Surgical treatment
Depending on the disease diagnosed and its progression, a surgical intervention may be performed such as an epididymectomy, partial or total removal of the epididymis.
Targeted treatment
In the event of a tumor and depending on its stage, chemotherapy or radiotherapy may be prescribed.
What you must remember
Infections linked to the epididymis can be severe and cause following-effects, it is important to treat them quickly and to exclude more serious underlying problems such as testicular torsion, with the consequences that this can cause: loss of a testicle, infertility… “In short: All sudden, brutal testicular pain must lead to an urgent medical consultation and even more so in young men: “Don’t say, we’ll see tomorrow if the pain has gone, but go and consult quickly” insists Dr Antoine Faix.
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