Surgery for epididymal cysts (spermatocelectomy)
A fluid-filled vesicle in the area of the epididymis is an epididymal cyst (spermatocele). It must be distinguished from an accumulation of tissue fluid in the scrotum, which is referred to as a hydrocele. Both conditions are often perceived as bothersome, so that surgical treatment via a small incision in the scrotum is possible.
Questions about the diagnosis and treatment of an epididymal cyst (spermatocele)
The epididymis lies on the side of the testicle and serves to mature and store sperm. The organ has long ducts coiled in a very small space. If a duct becomes blocked, a vesicle filled with protein-rich fluid, a so-called cyst, can form here. This is then referred to as a spermatocele.
About a third of men develop spermatoceles in the course of their lives. However, only some of the men affected by a spermatocele complain of symptoms.
A spermatocele typically becomes noticeable as a slowly increasing swelling of the scrotum, which is perceived as bothersome once it reaches a certain size. As a rule, there is no pain. However, patients often describe a pulling sensation or feeling of pressure in this area. Spermatoceles can occur singly or multiply, on one or both epididymides and with chambers.
A spermatocele is not dangerous. However, other, possibly serious causes of testicular swelling must be ruled out by a urologist. The diagnosis is easily confirmed by an ultrasound examination.
A spermatocele is treated surgically if the patient is impaired in everyday life. There is no clear limit as to the size above which surgery should be performed.
In addition to the clinical examination, an ultrasound examination is carried out.
In addition to the general risks of any operation, such as bleeding, inflammation and impaired wound healing, there are special risks with spermatocele surgery, such as injury to the testicle. It should be noted that, particularly in young patients who wish to have children, surgery can reduce fertility.
Surgery for epididymal cysts (spermatocelectomy) at a glance
| Indication | bothersome/painful enlargement of the scrotum |
| Principle | Removal of the fluid-filled vesicle of the epididymis |
| Operating time | approx. 30–45 min |
| Hospital stay | 1–2 nights |
| Note | General anaesthesia or spinal anaesthesia |
Questions about surgery for an epididymal cyst (spermatocele)
Through an incision, the testicle and epididymis including the spermatocele are removed from the scrotum. The cyst is then separated from the epididymis at its edge. The testicle and epididymis are placed back in the scrotum and the wound is sutured.
Patients are admitted on the day of the operation. After the operation, inpatient treatment for 1–2 days is recommended. During this time, the testicle should be elevated and cooled. You should not work until one week after discharge and should take it easy physically.
The chances of success of the operation are very good. As a rule, a new spermatocele requiring treatment does not occur on the same epididymis.
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Epididymal cyst (spermatocele)
What to do about a cyst in the epididymis?
A palpable lump on the epididymis is often not cancer, but a benign epididymal cyst, also known as a spermatocele. Find out everything important about it in this video.
- Definition: A spermatocele is a fluid-filled cavity on the epididymis. It can be a few centimetres in size or, in rare cases, fill the entire scrotum. It usually causes no symptoms, occasionally a feeling of pressure or problems when wearing tight clothing.
- Diagnosis: The spermatocele is detected by palpation and anatomically assigned to the epididymis.
- Treatment: Surgery is only necessary if there are symptoms. The testicle is exposed via a small incision in the scrotum, and the cyst is carefully detached from the epididymis and removed. Particular care is taken not to damage the sperm transport pathways in order to preserve fertility.
- Goal: Pain relief and removal of the cyst while preserving the function of the epididymis. Smaller, symptom-free spermatoceles can simply be monitored.
About this page:
Author
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.
