What is a spermatocele?

A spermatocele, also known as a spermatic cyst, is a fluid-filled sac that develops in the epididymis, which is a long, tightly coiled tube that the sperm passes through to be ejaculated. The epididymis is located in the scrotum and surrounds the top and the back of each testicle.

The cyst is usually pain-free, and mostly occurs close to a testicle. It is filled with a whitish, cloudy fluid and may also contain dead sperm. Spermatic cysts vary in size and don’t hurt, but could cause pain if they grow too large. Fortunately, they are not cancerous and are not a sign that testicular cancer is present. However if you do notice a growth near your testicles, penis or scrotum, see your doctor to have it checked out.

Note that spermatoceles do not impact negatively on fertility.

What causes a spermatic cyst?

Studies have shown that these cysts often contain pools of dead sperm, but doctors are still unsure what the actual cause is. Spermatic cysts seem to pop up for no specific reason. The studies have also revealed that spermatoceles are quite common. It is estimated that about 3 out of 10 men will probably get them, but men aged between 30 and 50 will be more prone to develop the cysts.

Although not cancerous, they also do not raise the risk of getting testicular cancer.

What are the symptoms?

Most of the time a spermatocele does not hurt, so you may not have any physical symptoms at all. However, it is a good idea to regularly self-examine the testicles for any sort of lump or swelling, whether painful or not. If there is a spermatic cyst present, as it grows you may feel a heaviness in the testicle, or a mass or swelling behind one or both testicles.

If you feel something is not right, make a point to visit the doctor for an examination.

Diagnosing a spermatic cyst

The doctor will do some tests to make sure the lump or swelling is not anything sinister, starting with a physical exam.

If the doctor is still uncertain, the following tests may be ordered:

• Trans-illumination. This is a strong light which is shined through the scrotum. If it is indeed a spermatic cyst, the light will indicate that the mass is fluid, rather than solid.
• If a cyst is not clearly indicated, an ultrasound can help to establish what the lump or mass might be. The images of the swelling can determine whether it is a testicular tumour or another medical condition.

The correct diagnosis is important as different conditions require different treatments.

Treatment protocol for a spermatocele

This cyst may not go away on its own, but most of them do not need treatment, unless it keeps growing and causes discomfort. If your cyst is painful the doctor might recommend over the counter meds such as ibuprofen or Tylenol. But if the spermatic cyst keeps growing in, a minor surgical procedure might be necessary to separate the cyst from the epididymis. This can be done in a day hospital, under a local or general anaesthetic. Complications are rare, and a follow-up examination is required after 2 or 3 weeks. Over-the-counter pain meds will suffice.

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