Epididymal stones are also known medically as seminal vesicle stones, and stones that occur in the seminal vesicles are called seminal vesicle stones. They are extremely rare in clinical practice. They are formed when inorganic salt crystals are deposited on exfoliated epithelial cells and inflammatory exudates due to chronic inflammation of seminal vesicles, obstruction of ejaculatory ducts, retention of seminal fluid, and metabolic disorders. Stones are often multiple, usually small, 1 to 2 mm in size, with a smooth and hard brown surface. They may occur singly or multiple times and are rarely symptomatic, with occasional hematemesis, painful ejaculation, or perineal discomfort. Spermatoceles are rare, with round, hard and smooth stones. What are the causes of epididymal stones? Corriere reported that the composition of seminal vesicle stones is very similar to pancreatic stones, while the formation of pancreatic stones is associated with abnormal expression of the gene that secretes pancreatic stone protein, thus it is believed that the formation of seminal vesicle stones is due to the lack of protease in the seminal fluid. Spermatoceles are often associated with chronic inflammatory changes and fibrosis, and the seminal vesicles may be completely obstructed. Spermatocystic stones can be single or multiple, with a core of epithelial cells and mucinous material and external deposits of salts, 1 to 2 mm in diameter, some up to 1 cm stones, with a hard surface. Testicular stones are mostly formed by incomplete treatment of epididymitis and can be accompanied by chronic prostatitis, often without symptoms, but also with pain in the groin, which can radiate to the testicles and perineum. The stone is lodged in the ejaculatory duct. When the stone obstructs the discharge of semen, it can cause colic. The symptoms are aggravated during erection or ejaculation. Bloody semen may be present. On rectal examination, multiple hard stones with smooth surface may be palpated at the upper outer edge of the prostate, or there may be a feeling of stone friction. X-rays may reveal stone shadows in the seminal vesicles.