Overview

A spermatocele is an often pain-free benign cyst that occurs close to a testicle. It may also be known as a spermatic or epididymal cyst.

The cyst forms in the epididymis. The epididymis is a coiled tube behind each testicle. The cyst is filled with fluid and may contain dead sperm. Read on to learn more about identifying and treating this condition.

Symptoms

Spermatoceles cannot be seen during a visual exam. That’s because they’re contained within the scrotum. They can be felt, however. A spermatocele feels like a smooth, but separate, firm lump. The lump is found near the top of, or behind, a testicle.

Spermatoceles are most likely to be discovered during your yearly physical when your doctor checks for any signs of a testicular growth. Spermatoceles are benign and only appear in the scrotum. That means they’re not a sign of testicular cancer.

If the cyst grows too large, you may feel discomfort or pain in the testicle. You may also experience heaviness, as well as a feeling of fullness in the testicle.

A mass in your scrotum could signal another issue as well. Talk to your doctor about any unexplained lumps in your scrotum. That way they can rule out more serious causes and come up with a treatment plan.

Do spermatoceles cause infertility?

Doctors don’t consider spermatoceles a cause of infertility. It may reduce the quantity and quality of sperm produced if the spermatocele is large, however. If you’ve been trying to conceive for over a year and are concerned about your fertility, talk to your doctor. There are several possible causes for male infertility. The first step is having a semen analysis to determine the health of your semen.

Causes

Researchers don’t know what causes spermatoceles. Spermatoceles are neither cancerous nor do they increase your risk of testicular cancer.

Diagnosis

A spermatocele can be diagnosed through a detailed examination of the genital area. Your doctor will feel your testicles to search for masses, or areas that are tender or painful to the touch. You can expect to feel some pain when your doctor touches the affected areas.

Your doctor may also do the following tests:

  • Transillumination. By passing a light through the scrotum, your doctor can examine the entire area. Any spermatocele should be clearly seen.
  • Ultrasound. If transillumination isn’t successful, an ultrasound can be used by your doctor to look inside the scrotum to search for a cyst.

Treatment

Spermatoceles aren’t cancerous and are usually pain-free. Most people won’t need treatment. Instead, your doctor will monitor the cyst during regular doctor appointments.

Spermatoceles may require medical attention if they grow too large or begin to cause pain.

Medical therapy

Medical therapy is limited to oral medications to fight pain and reduce swelling. No drug has been developed to cure or prevent spermatoceles.

Minimally invasive therapies

There are two minimally invasive therapies available, but these are rarely used.

  • Aspiration. Your doctor will use a needle to puncture the spermatocele and then drain the fluid.
  • Sclerotherapy. Your doctor will inject an irritating agent into the cyst. This promotes healing and discourages the fluid from accumulating again.

These therapy options have been shown to work, but they aren’t usually recommended. That’s because there’s a risk that the epididymis may be harmed, leading to fertility problems. Another common problem is that the spermatoceles can come back.

Surgical therapy

Surgical therapy known as spermatocelectomy is the most common treatment for a symptomatic spermatocele. The aim is to remove the cyst from the epididymis while, at the same time, preserve the genital system. This surgery is done as an outpatient procedure. That means you won’t need to stay in a hospital overnight. It may be done with either local or general anesthesia, and it’s usually complete in under an hour.

Sometimes part or even all of the epididymis may need to be removed along with the cyst.

Outlook

Most people won’t experience any symptoms from a spermatocele. If you do experience pain or discomfort, spermatocelectomy should provide relief, though there is risk for complications that may affect fertility. It's also possible that your spermatocele might come back, even after surgery.

Discuss the risks and benefits of treatment options with your doctor, and let them know about any concerns you have, including the effect treatment will have on fertility.

Q&A: Spermatocele vs. hydrocele

Q:

What’s the difference between spermatoceles and hydroceles?

A:

Spermatoceles and hydroceles are both benign conditions that are found around the testicular region, but they arise from different origins. Spermatoceles are cysts that form in the tubules leading to the testis. Hydroceles are collections of clear fluid that form between the layers of tissue surrounding the testicles.

Elaine K. Luo, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.