Spermatocele

Overview

A spermatocele (SPUR-muh-toe-seel) is an abnormal sac (cyst) that develops in the epididymis the small, coiled tube located on the upper testicle that collects and transports sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm. The exact cause of spermatoceles isn't clear, but they might be due to a blockage in one of the tubes that transport sperm. Spermatoceles are common, and they typically don't reduce fertility or require treatment. If a spermatocele grows large enough to cause discomfort, your doctor might suggest surgery.

Understanding the disease

Symptoms

Spermatocele is an abnormal sac (cyst) that develops in the epididymis, the small, coiled tube located on the upper testicle that collects and transports sperm. Spermatocele is generally painless and filled with milky or clear fluid that might contain sperm. If a spermatocele grows large enough to cause discomfort, you might feel pain or discomfort in the affected testicle, heaviness in the testicle with the spermatocele, or fullness behind and above the testicle. However, many spermatocele cases do not cause symptoms and might remain stable in size. If you experience pain or swelling in your scrotum, you should see a doctor to rule out a serious condition, such as testicular cancer.

Development

A spermatocele is an abnormal sac or cyst that develops in the epididymis, which is the small, coiled tube that collects and transports sperm in the upper testicle. Spermatocele causes aren't entirely clear, but it might be due to a blockage in one of the tubes that transport sperm. The exact cause of spermatoceles is unknown, but it is generally noncancerous and painless. Spermatoceles are common and typically don't reduce fertility or require treatment unless they grow large enough to cause discomfort, in which case surgery might be suggested.

Assessment and Diagnosis

Triage

You should see a doctor if you suspect a spermatocele, particularly if you experience pain or swelling in your scrotum. While spermatoceles are generally painless and don't require treatment, it's important to have a doctor evaluate any scrotal mass to rule out more serious conditions, such as testicular cancer. Additionally, call your doctor if you experience any discomfort or pain in your scrotum, as numerous conditions can cause testicular pain and some may require immediate treatment.

Diagnosis

To diagnose a spermatocele, you will need a physical exam. During the physical exam, your doctor will check for a fluid-filled mass in your scrotum. Additionally, diagnostic tests such as transillumination and ultrasound may be performed to confirm the presence of a spermatocele and rule out other conditions like testicular tumors. A testicular biopsy may also be done in certain situations to check for abnormalities in sperm production.

Management and Treatment

Complications

Complications of a spermatocele are unlikely, but some possible complications include:

1. Pain or discomfort: If the spermatocele becomes large enough, it may cause pain or discomfort in the affected testicle.
2. Reduced fertility: Surgical removal of a spermatocele may damage the epididymis or the vas deferens, potentially reducing fertility.
3. Recurrence: Although rare, there is a possibility that the spermatocele may return after surgery. It is important to have a doctor evaluate any scrotal mass to rule out more serious conditions, such as testicular cancer. Also, if you experience pain or swelling in your scrotum, you should contact your doctor, as various conditions may cause testicular pain and may require immediate treatment.

Treatment

Spermatocele is a fluid-filled cyst in the epididymis, and most of them don't require treatment as they usually don't cause pain or complications. If the spermatocele is causing pain, over-the-counter pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) can be taken to ease discomfort. However, if the pain persists or the spermatocele grows significantly, surgical treatment may be considered. A spermatocelectomy is a procedure that involves making an incision in the scrotum to remove the cyst. After surgery, you might need to wear a gauze-filled athletic supporter to apply pressure to the site of the incision, and follow-up exams are recommended between one and three weeks after surgery.

Preparing for medical consultation

To prepare for an appointment for spermatocele, you should:

1. Be aware of any pre-appointment restrictions: Ask your doctor if there are any specific instructions you need to follow before the appointment. If a semen analysis is scheduled, refrain from ejaculating for at least two to five days prior to the collection.
2. Write down symptoms and personal information: Note down any symptoms you are experiencing, including those that may seem unrelated to the reason for your appointment. Also, jot down key personal information, such as any testicular injuries or previous surgeries.
3. Gather information about your family history: Find out if you have a family history of fertility problems or other reproductive issues. This may provide clues to the cause of your fertility issues.
4. Prepare a list of questions: Compile a list of questions to ask your doctor during your appointment. Some questions to consider include the likely cause of your symptoms, the necessary tests, the potential side effects of treatment, and the expected timeline for recovery.
5. Bring previous medical records: Ensure you bring any previous medical records, test results, or relevant documents to the appointment. This will help provide context for your doctor and ensure they have all the information needed.