Small, Painful, Hard Lump on Epididymis – Common Causes, Symptoms, Treatment

The epididymis is a highly coiled tube located on the top to behind the testicles. Sperm produced in testicles is stored in this organ. The epididymis can be felt and sometimes be taken for a lump on the testicles. It feels very soft and spongy.

A lump on the testicles is one of those conditions you can’t help but be concerned about. Not many men are familiar with the exact anatomy of their reproductive organs. With cases of prostate and testicular cancer being on the rise, a lump on epididymis can be taken for a sign of malignancy. This is not to mention the natural fear that strikes when a lesion or a mass is discovered in the genital region.

Luckily, most common causes of epididymal lumps are fairly harmless. This article discuses them, their symptoms and available treatment options. All the same, a medical diagnosis is the only certain method to confirm if a lump is dangerous or not.

Soft lump on epididymis; spermatocele (epididymal cyst)

The epididymis head, body and tail are the three main sections of the epididymis. The epididymis head is located at the top of the testicle. The body is the highly coiled section which stores sperm while the epididymis tail is the lowest part, located behind the testicle.

Most epididymis hard lumps are caused by spermatocele or epididymal cysts. These are noncancerous sacs filled with fluid that form in epididymis. They are generally harmless, painless and do not reduce fertility.


It is not clear what causes this condition. A blockage in the epididymis is the most likely cause. Most cases are reported in men above 35 years of age.


Most people who have epididymal cysts don’t realize it. The most common symptom is a soft lump or mass on top of your testicle. Small epididymal cysts do not cause any pain but large ones can be painful and cause discomfort. The affected testicle may also feel heavier.

Diagnosis and treatment

Your doctor will perform a physical exam. To rule out cancer, transillumination may be performed. This involves shining a light behind each testicle. If a tumor is present, the light will not shine through.

Epididymal cysts do not require treatment. If necessary, such as when the lump causes pain, it can be removed through surgery.

Painful epididymis lump; Epididymitis

A painful epididymis lump can be caused by epididymitis, which is an inflammation of the epididymis. If the testicles are also swollen, it is referred to as epididymo-orchitis.


STDs are the most common causes. It is for this reason that the condition is more common in men between 15-35 years of age. Bacteria or virus can travel from the urinary tract and infect the epididymis. Sometimes, infections are introduced into the body system during surgical operations such as to remove a lump below sternum caused by a hernia. Other possible causes and risk factors include:

  • TB
  • Viral infections such as mumps
  • Injury
  • Urinary tract structural problems which make urine flow back
  • Unprotected sex
  • Groin or urinary tract surgery


Epididymitis may cause the following signs and symptoms:

  • Painful epididymis lump or swelling. The swelling may also occur in testicles
  • Redness and warmth on scrotal skin
  • Pain in groin area
  • Swollen lymph nodes in groin area
  • Pain when urinating
  • Frequent urge to urinate
  • Penile discharge
  • Slight fever
  • Bowel movements

If the symptoms last for about 5 weeks, it is referred to as acute epididymitis. If they are to last longer than six months or keep recurring, it is referred to as chronic epididymitis.

Diagnosis and treatment


Your doctor will perform a physical exam and ask a few questions such as the symptoms you have been experiencing, when they started and your medical history.

Additional tests to check for urinary tract infections, prostate enlargement and STDs may also be performed. STDs usually cause lumps, lesions or bumps elsewhere around the genital area. Tell your doctor about signs such as lump near the anus even if not painful, itchiness in genital area and like. If necessary, imaging tests will be done.


Epididymitis is an infection and requires medical treatment. Otherwise, it can spread or cause damage to your epididymis.

Treatment is usually done with antibiotics, anti-inflammatory medications and pain relievers. The underlying infection that caused the infection will also be treated. Otherwise, the infection can keep recurring.

See your doctor if you notice inflammation or swelling in your epididymis and testicles. This is especially if the swelling is causing a lot of pain.

Lump on epididymis after vasectomy

Vasectomy is a surgical procedure that sees the vas deferens cut and tied at both ends. Sperm in epididymis tail drain into the vas deferens. This is the tube that transports sperm to the urethra before ejaculation. After a vasectomy, men are not able to ejaculate but can still have normal sex. Recovery from a vasectomy is not usually complicated. Sometimes, a lump can appear in or near epididymis after a vasectomy. This can be caused by:

Sperm granulomas

A small lump in epididymis after vasectomy can be a sperm granuloma. After a vasectomy, sperm may leak at the tied ends towards the epididymis. These small lumps are not harmful.


A hematoma is a blood clot that forms outside blood vessels. This usually occurs after an injury damages blood vessels. You can for example develop a hematoma painful lump on top of foot when hit with a blunt object. Small hematomas near the epididymis after a vasectomy are not harmful. They resolve without treatment. If accompanied by pain and swelling, see your doctor for surgical correction.


Mild swelling near epididymis is common after vasectomy. See your doctor if symptoms such as fever, swelling, redness and warmth on the incision site occur. These are signs of infection.

Congested sperm

A vasectomy does not take away the ability to produce sperm. In fact, the process has recently become reversible. Since sperm will continue to flow into the epididymis, congestion can occur and cause swelling. This can be felt as painless, small lump on epididymis. It usually resolves without treatment.

Other possible causes of lump on epididymis

It is sometimes a bit challenging to tell if a lump is on the epididymis, testicle or scrotum. Other possible conditions that can result in lumps in this area include:


This is a very common cause of testicular lumps. It is caused by accumulation of fluid around the testicle. Hydrocele mostly develops after injury or surgery.


Varicocele refers to enlargement of veins located at the back of testicles. This condition tends to affect the left testicle more often. It results in small masses near epididymis that disappear when you are lying down.


Testicular cancer is the most common type of cancer that can develop near epididymis. Like other types, it develops when cells divide rapidly and abnormally to create lumps on or in testicles. Although testicular cancer is not very common, it is very dangerous and requires immediate treatment. See your doctor if you notice a lump that seems to have come out of nowhere or gradually adds mass.

When to see a doctor

Your doctor should have the final say on whether a lump on epididymis is harmless or not. It is therefore advisable to seek medical help if a lump causes any form of discomfort, especially pain. For painless lumps, see your doctor if the lump persists for more than 2 weeks.

There is a lot to learn about the different types of lumps that can occur on your body. Such include a hard lump on the roof of the mouth, breast lumps, lump in the throat after eating, causes of abdominal masses and so on. So many types of diseases and health conditions have found their way in today’s world. Luckily, modern medicine has greatly advanced. The most important thing is to get a disease, infection or condition discovered the earliest possible.


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