Epididymis

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Behind each testicle is the epididymis. Firm to the touch, it is basically a massively coiled tube (nearly 20ft long!) that allows spermatozoa to mature. Once matured, the semen passes into the vas deferens for its grand voyage.

Spermatic Cord

The cord running from each testis to the top of the scrotal cavity. Most important contents are testicular artery and vein, and vas deferens.

Clinical Conditions

Epididymo-orchitis

An inflammation of the testis due to an initial inflammation of the epididymis. The commonest cause is a UTI with coliform organisms, though also happens after prostatectomy. Can also be caused by tuberculosis.

Varicocele

Involves the pampiniform plexus. Can be harmless, commonly on the left hand side, due to the blood supply draining to the renal vein on the left, which is at a high pressure. The right drains into the inferior vena cava, at a lower pressure, so it is less common. A secondary varicocele is because of venous obstruction – it can signify carcinoma of the kidney invading the renal vein, if on the left. The commonest problem with varicoceles is that they raise the scrotal temperature, causing reduced fertility.

Torsion

Twisting of the testis and cord. Presents as acute abdominal or testicular pain. The patient is usually 13-16, or under 1. Often occurs after exertion. If not treated as a surgical emergency, infarction of the testis can occur.

Spermatocele

A cyst forms in the epididymis. Not very interesting really, but probably quite scary if you get one.