Surgery for epididymal cysts (spermatoceles surgery)

A fluid-filled bubble in the area of the epididymis is known as an epididymal cyst, or a spermatocele. The epididymal cyst can be distinguished from an accumulation of fluid in the scrotum, which is known as a hydrocele. Both conditions are often perceived as disturbing and may cause discomfort. Surgical treatment is possible via a small incision in the scrotum.

Questions on the diagnosis and treatment of an epididymal cyst (spermatocele)

The epididymis rests on the side of the testicle and serves to mature and store the sperm. The organ has long, winding ducts in a very small space. If a duct is blocked, a bubble filled with protein-rich fluid, known as a cyst, can form here. This is called a spermatocele.

About one third of men develop spermatoceles over the course of their lives. However, only some of the affected men complain of symptoms.

Typically, a spermatocele is noticed when the scrotum slowly swells, which can be perceived as disturbing if it is large enough. There is usually no pain. However, patients often describe a feeling of pulling or pressure in this area. Spermatoceles can occur individually or several times, on one or both epididymis, or in a chamber.

A spermatocele is not dangerous. However, a urologist must rule out other, possibly serious causes. The diagnosis is easily confirmed by an ultrasound examination.

Treatment is recommended at the very latest when the spermatocele interferes with the patient’s everyday life. There is no clear limit on what size the spermatocele must be before surgery can be performed.

In addition to the clinical examination, an ultrasound examination is performed.

In addition to the general risks of any surgical procedure, such as bleeding, inflammation, and interruption of wound healing, there are risks unique to spermatoceles surgery such as testicular injury. It should be noted that, especially in young patients who may intend to have children, an operation can reduce fertility.

Brief information on spermatocele surgery

Indication Disturbing/painful enlargement of the scrotum
Procedure Removal of the fluid bladder of the epididymis
Surgery time Approx. 30-45 minutes
Clinic stay 1-2 nights
Note General anaesthesia or spinal anaesthesia

Questions about surgery for an epididymal cyst (spermatocele)

The testicle and epididymis, including the spermatocele, are removed from the scrotum through an incision. The cyst is then carefully separated from the epididymis. The testicle and epididymis are placed back in the scrotum and the wound is sutured.

Admission for the procedure takes place on the day of the surgery. After the operation, inpatient treatment is recommended for 1-2 days. During this time, the testicle should be elevated and cooled. It is recommended not to work for 1 week after being discharged and avoid physical exertion.

The chances of success of the procedure are very good. A new spermatocele requiring treatment does not usually reoccur on the same epididymis.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020