What is a spermatocele?

A spermatocele is a cyst in the epididymis, which is a tube in a man's testicle that stores and transports sperm. This type of cyst is usually small and benign. It often contains a milky fluid, which usually contains dead sperm. Most men who have a spermatocele will not require treatment unless it becomes very large or uncomfortable. In this case, surgery to remove the spermatocele is often recommended.

Spermatoceles often cause no symptoms at first. They are usually less than 0.5 inches (1.27 cm) and are often only felt during testicular self-exams or testicular cancer screenings. If they grow, they can cause pain, swelling, or a feeling of heaviness in the testicle.

To diagnose a spermatocele, a health care provider will often perform a manual exam. He may also shine a light into the scrotum to see if the lump you feel is fluid-filled or solid. Light will usually pass through this type of fluid-filled cyst, but it will not usually pass through a solid mass, such as a hernia or cancerous growth. Your health care provider may also recommend a testicular ultrasound, which can also help show whether or not the mass is filled with fluid.

If a spermatocele becomes enlarged and/or causes symptoms, a health care provider may recommend surgery called a spermatocelectomy. In general, a spermatocelectomy involves opening the scrotum and removing the spermatocele cyst through the opening. As with most surgeries, there can be risks to this procedure. For a particular spermatocelectomy, risks commonly include infertility, bruising, and pain.

Another less common spermatocele treatment is sclerotherapy. This procedure is usually done by making a small incision in the scrotum and inserting a needle into the cyst to draw out the fluid. A chemical is usually injected into the empty cyst sac. This chemical usually helps scar tissue grow inside the sac, which can help prevent the sac from refilling with fluid. There may also be risks associated with this procedure, such as infertility, bleeding, and infection.

Because spermatoceles usually don't cause problems and procedures to remove them can have serious risks, many health care providers suggest monitoring them until treatment is needed. Regular self-exams and checkups with a health care provider can help detect any changes in the spermatocele. They can also often help find other masses that need attention.

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