Epididymal Cyst: Causes, Treatment, and Potential Risks
An epididymal cyst is a fluid-filled sac that forms in the epididymis. The epididymis is a tube at the back of the testicles where sperm is stored and matures before moving to the vas deferens.
Epididymal cysts, also called spermatoceles, are usually small and non-cancerous. They often do not cause any symptoms and might be found during a routine check-up.
In some cases, what appears as a general cyst testicle may actually be an epididymal cyst upon closer examination. Although they are generally harmless, it's important to see a doctor if you notice any lumps or changes in your testicles. In rare cases, the cyst can become large or uncomfortable, which might require treatment or removal.
What Are Epididymal Cysts?
Epididymal cysts are benign — non-cancerous — growths that occur in the epididymis. The epididymis is a coiled tube situated at the back of each testicle that helps in the storage and transport of sperm.
These testicular cysts are filled with a milky fluid that may contain sperm. They vary in size, and they can be as small as a pea or as large as a grape. A cyst epididymal head is a term commonly used in ultrasound reports to specify the cyst's location within the upper segment of the epididymis.
Most men with cysts do not experience any symptoms or discomfort. However, if the cyst is significantly large, as of the size of the grape, you may experience heaviness and discomfort in the scrotum.
Spermatocele vs. Epididymal Cyst
Epididymal cyst and spermatocele are two different words for the same condition — the formation of a fluid-filled sac in the epididymis. However, there is a very slight difference in the representation of both terms. The debate between spermatocele vs epididymal cyst mainly comes down to whether or not the cyst contains sperm cells, although they are managed similarly.
Epididimal cyst or testicular cyst epididymal refers to a fluid-filled sac that may not contain sperm. However, spermatocele refers to the fluid-filled sac that also contains sperm cells.
You will experience the same spermatocele symptoms as with the cyst in epididymal head. The medical management is also the same for both conditions. Remember, epididymal cysts and spermatoceles are not cancerous growths, and they may not cause any harm and go unnoticed.
Is Epididymal Cyst Same as Cyst On Scrotum?
No, the epididymal cyst has a different location than the cyst on scrotum skin or cyst on balls. In an epididymal cyst, the fluid-filled sac develops in the epididymal head, which is a tube behind the testes. A cyst on epididymal head is internal and different from more superficial lesions found on the scrotal skin.
Cyst on the scrotum develops just under the scrotum skin and can be visible easily. A cyst on skin of scrotum typically appears as a raised bump and is often a sebaceous cyst, unrelated to the reproductive structures. Cyst on the skin of the scrotum or cyst on ballsack is also generally harmless and doesn’t cause any severe complications.
Another rare condition is the cyst spermatic cord, which occurs along the cord that carries sperm from the testes, and may sometimes be mistaken for other scrotal lumps. Besides epididymal cyst and skin cyst scrotum, there is another type called cyst of the spermatic cord. As the sperm flow through the spermatic cord, cysts of the spermatic cord can be a risk to fertility.
Symptoms of Epididymal Cysts
Epididymal cysts are often asymptomatic, meaning that you don’t experience any symptoms in this condition. Many men discover them during a self-exam or a routine physical check-up.
However, if the cyst is large enough, you may experience symptoms such as heaviness in the testicles, discomfort, or a lump.
The severity of symptoms can vary depending on the size of the cyst. If the cyst is large, it may cause more severe pain and discomfort.
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Always remember that severe testicular pain needs immediate medical attention. This could be a sign of a more serious condition like testicular torsion.
Causes and Risk Factors
Studies indicate that there is no exact cause for epididymal cysts. Experts believe that epididymal cysts develop due to fluid buildup in the epididymis.
Here are some common risk factors for the development of epididymal cysts:
- Blockage of Tubules: A blockage in the epididymis or tubes that carry sperm can cause fluid build-up and develop epididymal cysts.
- Infections: Infection and inflammation in the epididymis can lead to the formation of cysts.
- Vericocele: It is the formation of varicose veins in the testicles, which feels like a “big of worms.” Vericocele can feel like epididymal cysts, and it can also lead to the formation of cysts.
- Previous Surgery: If you had previous surgery on a scrotal area, there is a chance of developing an epididymal cyst.
However, epididymal cysts can also develop in the absence of these risk factors. It is important to consult your healthcare provider if you suspect consistent pain and discomfort in the scrotum.
Diagnosing Epididymal Cysts
Since epididymal cysts don’t cause any major symptoms, many men discover it first during self-examination. A physical examination by doctors can also help find this condition.
The doctor may feel a small, round lump in the scrotum. However, a physical exam alone is not enough to confirm the diagnosis.
Imaging techniques such as ultrasound can help differentiate an epididymal cyst from other types of testicular masses. Ultrasound can provide detailed images of the testicles and surrounding structures. Detailed testicular cyst pictures or spermatocele images by ultrasound help to identify the cyst in epididymis head and assess its size and location.
Early diagnosis helps in preventing serious complications such as testicular cancer.
That’s why it’s so important to visit a specialist not only for check-up but also for a sperm analysis.
But where do you go to get a sperm analysis? You can read more detailed information in our other article.
Treatment Options for Epididymal Cysts
Whether you need epididymal cyst treatment depends on several factors, such as the size of the epididymis cyst, level of discomfort, and risk of complications.
No Treatment
If the scrotum cysts are small and cause no discomfort, you can leave them untreated, and they won’t cause any harm. However, if the cyst in head of epididymis increases in size and causes discomfort, doctors advise medical management for such epididymal cysts.
Medication
When cyst on testicle or scrotal cyst develop due to infections, medication plays an essential role in the management of the condition. Common medications include antibiotics and pain relievers to manage the symptoms and prevent complications.
Surgery
The most common treatment option for larger cysts is the surgery to remove the cysts. The surgical procedure for the removal of epididymal cysts is called epididymectomy or spermatocele removal.
Managing Symptoms at Home
While medical management is vital for larger cysts, you can also take some measures to reduce pain and discomfort at home.
You can take over-the-counter pain relievers to manage pain associated with the epididymal cyst. Applying a warm compress to the scrotum can also provide relief. You must wear supportive underwear as it can help reduce discomfort, especially during physical activities.
In addition to that, avoid activities that worsen the pain and discomfort. Keep in mind that home management techniques for cysts can help improve symptoms but are not a replacement for medical management by an expert.
When to See a Doctor
You need to immediately consult your doctor if you notice a lump in your scrotum during self-examination. While epididymal cysts are usually harmless, the presence of a lump in the scrotum can be an indication of other serious conditions, such as testicular cancer.
The Impact on Fertility and Sexual Function
Evidence shows that epididymal cysts are not associated with infertility. A study conducted by the American Journal of Men’s Health found epididymal cysts in 73% of infertile and 67% of fertile men. The study shows that epididymal cysts don’t influence male fertility status.
However, if the cyst becomes large or uncomfortable, it can interfere with sexual activity. Also, if the cyst is due to some underlying health condition, it can influence fertility. We recommend you consult your healthcare provider for a detailed evaluation of your condition.
Key Takeaways About Epididymal Cysts
Epididymal cyst or spermatocele is a condition in men where a filled sac develops in the epididymis. An epididymal cyst is usually harmless, and it doesn’t lead to any serious complications. In most cases, people may not even know they have an epididymal cyst because it doesn’t cause any prominent symptoms.
However, if you suspect the presence of scrotal mass during testicular self exam, it is a good idea to talk about your condition to an expert. This helps in early diagnosis and efficient management of cysts and other complications.
FAQs
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Do spermatoceles can impact fertility?
Spermatoceles are benign growths of fluid-filled sacs on the epididymis. It doesn’t impact fertility because it does block the tubes that transport sperm.
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How to shrink a spermatocele?
Spermatocele doesn’t require treatment in most cases. However, surgical removal is the preferred treatment option for larger spermatoceles.
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Shop Now →Can an epididymal cyst affect fertility or sperm production?
Epididymal cysts are typically benign and do not affect fertility or sperm production in most cases. Since the cyst is a fluid-filled sac that forms alongside the epididymis rather than replacing it, normal sperm transport and maturation usually continue unaffected. However, if a large cyst causes obstruction or complications, you should consult a fertility specialist to assess any potential impact on reproductive function.
How is an epididymal cyst diagnosed?
Epididymal cysts are most commonly diagnosed through a scrotal ultrasound, which is the gold standard imaging test recommended by urologists in the US. During the ultrasound, a technician can visualize the cyst's location, size, and whether it contains fluid or sperm. Many cysts are discovered incidentally during routine physical exams or imaging performed for other reasons.
When should I see a doctor about a testicular lump?
You should see a urologist or primary care physician as soon as possible if you notice any new lump, swelling, or change in your testicles, even if it's painless. While most testicular lumps are benign like epididymal cysts, only a medical professional can rule out serious conditions through physical examination and imaging. The American Urological Association recommends prompt evaluation of any testicular abnormality for peace of mind and proper diagnosis.
What are the treatment options for an epididymal cyst?
Since epididymal cysts are benign and asymptomatic in most cases, the standard approach is watchful waiting with periodic ultrasound follow-ups rather than immediate treatment. If the cyst causes pain, discomfort, or functional issues, treatment options include pain management medications or surgical removal (aspiration or excision) performed by a urologist. Most insurance plans in the US will cover surgical treatment only if symptoms are documented and conservative management has been attempted.
Is an epididymal cyst cancerous?
No, epididymal cysts are benign, non-cancerous growths and do not develop into cancer. They are fluid-filled sacs that form naturally in the epididymis and pose no cancer risk to your health. If you have concerns about any testicular lump, a urologist can confirm through ultrasound that it is a benign cyst rather than a malignant tumor.
Can an epididymal cyst go away on its own?
Many epididymal cysts remain stable in size and may never require treatment, though they typically do not disappear completely on their own. Some cysts may slightly change in size over time, which is why periodic ultrasound monitoring is recommended if you're not experiencing symptoms. Spontaneous resolution is uncommon, but the cyst's stable nature means most men can safely monitor it without intervention.
Does insurance cover removal of an epididymal cyst?
Insurance coverage for epididymal cyst removal varies by plan and typically requires documentation of symptoms or functional impairment. Most US insurance plans, including Medicare, will cover surgical removal if conservative treatment has failed and the cyst is causing pain, discomfort, or complications. You should contact your insurance provider and have your urologist submit documentation to determine your specific coverage before scheduling a procedure.
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