The epididymis is a long coiled tube that lies above and behind each testicle. The epididymis collects and transports sperm from the testis to the vas deferens (tubes that transport sperm to the urethra). An epididymal cyst is a cyst-like mass in the epididymis that contains clear fluid.
Spermatoceles are similar to epididymal cysts. The only difference is that the spermatocele contains fluid and sperm cells. Usually one cannot tell the difference between them by physical exam or even by ultrasound. Both are benign, meaning they are not cancerous. They do not interfere with reproduction.
Typically, epididymal cysts and spermatoceles do not cause symptoms. When discovered, the epididymal cyst is usually about the size of a pea and feels separate from the top of the testis. Spermatoceles typically arise from the head of the epididymis, and are felt on the top portion of the testicle.
Epididymal cysts and spermatoceles are often incidental findings on testicular self-examination or routine physical examination. It is important that any mass noted in the scrotum be examined by a urologist in order to obtain an accurate diagnosis, especially a mass on the testicle itself. Our team in the Division of Urology will typically be able to confirm the diagnosis on physical exam. However, a scrotal ultrasound may also be used in order to rule out other conditions.
Most epididymal cysts and spermatoceles do not need to be treated. We strongly encourage our adolescent patients to perform monthly testicular self-exams. In the office we will review this with your son. If the epididymal cyst or spermatocele increases in size or causes pain, we will discuss surgery.
Reviewed by: Division of Urology
Date: August 2011