spermatoceles
HYDROCELES AND SPERMATOCELES (SCROTAL CYSTS)
WHAT ARE HYDROCELES AND SPERMATOCELES?
They are both harmless, fluid-filled cysts around the testis. Both are fairly common, have similar treatments, do not lead to cancer, do not cause sexual or fertility problems, and usually cause no symptoms. Sometimes they may be painful or be of cosmetic concern where treatment is necessary. They can be confused with each other because of their similar appearance on physical exam, and sometimes an ultrasound is necessary for diagnosis.
A spermatocele is a cyst of the epididymis (a gland above and behind the testis where sperm are processed). These are usually a marble-sized swelling found just above the testis.
A hydrocele is a cyst around the entire testis and may make the entire testis seem larger, often 2-3 times the size of the other testis. The cause of both is usually unknown, but may be related to prior genital infection, trauma or surgery. Rarely, a testis tumor may lead to cyst formation and may often be confused on physical exam with a cyst.
HOW ARE THEY TREATED?
Fortunately, most of these cysts require no treatment and can be left alone. However, they often slowly enlarge with time and do not go away on their own. There are no medications, exercise or dietary ways to prevent or treat these cysts. Rarely, they are aspirated with a needle, but this treatment is usually discouraged because it provides temporary relief at best and may lead to infection or scarring. Both cysts are best treated with surgical incision, which usually requires an anesthetic, and takes 15-30 minutes as an outpatient procedure. Most patients need to stay off their feet for a couple of days afterwards and reduce their activities for a couple of weeks. The risks include bleeding and infection, as with any surgical procedure, and the recurrence rate of either is about 5%. While treatment will not lead to erectile problems, fertility could be affected (especially with spermatocele surgery), so treatment may be delayed until child bearing is completed.