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The testes and epididymis are paired structures, located within the scrotum. The testes are the site of sperm production and hormone synthesis, while the epididymis has a role in the storage of sperm. They are suspended from the abdomen by the spermatic cord, a collection of vessels, nerves, and ducts that supply the testes.
Epididymitis is inflammation of the epididymis; in younger males, this is likely due to sexually-transmitted infections, however in older men it is more likely enteric organisms. Its main differential is testicular torsion, where the spermatic cord and its contents twists within the tunica vaginalis, compromising the blood supply to the testicle. This is a surgical emergency and the only definitive way to ensure the blood supply to the testicle is with scrotal exploration.
Testicular cancer is the most common cancer in males aged 20-40yrs. Patients will present with a unilateral painless testicular lump and diagnosis is made through a combination of tumour markers and imaging. Treatment is with surgical removal of the testis and adjuvant treatments if required.
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