Epididymitis, Men’s Unspeakable Pain

Professor Bin Bin, The First Affiliated Hospital of Guangxi University of Chinese Medicine

2012-05-17

Translated by Wira Yudha on 2018-07-19

Epididymis is located in the posterior lateral part of the testicular. Epididymis is a convoluted tubule which is connected to the testicle through the testicular output tubule at the posterior aspect of testicle, and is suspended at lower end of spermatic cord together with testicle. Size of the epididymis is about 6 × 0.5 cm, while total length of the epididymis is around 400-600 cm, and diameter of the epididymis is 0.4-0.5 mm. The upper end of the epididymis is round and obtuse, called epididymis head, attached to upper end of the testicle; epididymis is slender and vertical, the lower end becomes thinner and becomes epididymis tail, and epididymis tail reflexes upward to become known as vas deferens.

Epididymis is an organ that stores sperm and further matures the sperm. Sperm is stored in the epididymis after testicular formation. It stays in epididymis around another 20 days to develop further before it has the ability to fertilize. Sperm directly taken out from testicle does not have fertilization ability. Many substances secreted by the epithelial epithelium such as choline glycerate, carnitine, glycoprotein and various enzymes and a small amount of androgen, these substances in addition to supplying sperm nutrition and enhancing sperm motility, also provide sperm for metabolism, maturation and maintenance of its normal physiological related function . Fluid found in epididymis is acidic in nature and has a high osmotic pressure (300-400 milliosmolar), low oxygen content, and high in potassium ion, all these conditions are suitable for sperm to be dormant. There sperm can survive for 4 weeks or longer. Epididymis epithelium has a strong absorption function, and 99% of the testicular sputum secreted by the supporting cells in the testis is absorbed by epididymis. The phagocytic cells in the epididymis can degrade and absorb sperm that are not discharged in time.

People often called epididymitis as prostatitis twin brother, many patients with prostatitis will be associated with epididymitis as urethritis is also very likely to cause inflammation of the epididymis. Mycoplasma, streptococci, staphylococcus, etc. are some common pathogens causing inflammation in epididymis. Another good example is gonococcal urethritis, if it is not treated in time, it can easily lead to both prostatitis and epididymitis.

The incidence of acute epididymitis is very rapid, epididymis will increase in size and become swollen in just a matter a few hours. In severe cases, the testicles will be inflamed to a size of an adult fist causing unbearable pain, to the point of difficult to walk and some patients may experience fever. Patients with urinary tract infection may feel frequent micturition, a sudden and powerful urge to urinate and pain during urination (odynuria). Chronic epididymitis is often caused by urethritis, chronic prostatitis or delayed by acute epididymitis and repeated episodes of pain in epididymis experienced by patients. Tiredness, alcohol, spicy food, and sexual excitement can aggravate the symptoms of epididymitis.

It is important to pay close attention to any pain near the nether region, because the function of the epididymis is closely related to fertility, a slight pain in the epididymis should be promptly consulted. According to our experience in treating epididymitis, traditional Chinese medicine Chái Jú Decoction (including chái hú, jú hé, zhǐ ké, gāncǎo, etc.) had been proven in many cases can quickly relieve the symptoms of pain and swelling. Patients with microbes such as bacteria or mycoplasma can be treated with antibiotics. Patients with urethritis and chronic prostate must treat these related diseases at the same time. Patients with epididymitis are often infertile and should check the quality of their semen in order to treat, improve sperm quality and restore reproductive function.