Epididymal cyst: symptoms, causes, diagnosis, treatment


An epididymal cyst is a fluid-filled cyst that resides in the epididymis , a coiled tube at the back of the testicle that stores and carries sperm. This creates a benign (non-malignant) tumor in the testicle and can become very common as you age.

Cysts of the epididymis are sometimes called spermatocele. But this is a different type of cyst in which the fluid within the cyst contains sperm. The epididymis cyst contains only fluid.

The epididymal cyst is also different from epididymitis , which is a painful inflammation of the epididymal ducts caused by a bacterial or viral infection.

This article will discuss epididymal cysts, including what causes them, their symptoms, and how to treat them.

Epididymal cyst symptoms

Cysts of the epididymis usually have no symptoms before they form within the epididymis. If present, you may notice a pea-sized (or larger) ball behind, above, or below one of your testicles. In spermatocele, the cyst is often located at the apex of the testicles.

Other symptoms of an epididymal cyst can include:

  • Dull pain in the scrotum (the sac that supports the testicles)
  • Sensation of heaviness in the scrotum.
  • Scrotum redness
  • Sensation of pressure in the lower part of the penis.
  • Pain or swelling in the back of the testicle;
  • Pain, swelling, or hardening of the testicle itself
  • Pain in the groin or lower back and abdomen.

Epididymal cysts generally do not cause severe or severe pain. In most cases, they are completely painless. If any of the above symptoms appear, you should see a urologist for a full examination.

Causes of the cyst of the epididymis.

Experts don't know what causes epididymal cysts to form. In the case of spermatocele, this may be due to a blockage of the epididymis. This causes fluid and sperm to accumulate.

Epididymal cysts are common and harmless. However, if you find a lump in your testicles, it is very important that you make an appointment with your doctor right away. They can identify a more serious cause of the bulge, such as a tumor or hernia .

Diagnosis of the cyst of the epididymis.

Epididymal cysts are usually found on testicular self-exam or during a checkup at your healthcare provider's office. To determine the cause, your doctor will perform a physical exam, which may include shining a light behind each testicle.

Using light will help the doctor determine if there are growths, such as swelling, that are preventing light from entering. If the tumor is an epididymal cyst or a spermatocele, light will be able to penetrate to the other side.

Your healthcare provider may also order an ultrasound of the scrotum. This test uses sound waves to look inside the scrotum. It can check the blood flow and show if the tumor is a cyst or something more serious.

However, it is not possible to determine whether a cyst is an epididymal cyst or a spermatocele by physical examination or ultrasound alone. This is why healthcare professionals often refer to both terms.

After determining the cause of the lump, your healthcare provider will likely refer you to a urologist to track your growth over time and treat any symptoms that may be associated with it.

Treatment of an epididymal cyst

Most epididymal cysts are treated only if they cause pain or discomfort. Once diagnosed, you can perform regular self-exams and consult with your doctor to monitor cysts.

Epididymal cysts and spermatocele generally shrink as the body reabsorbs fluid from the cyst or remains the same size. However, occasionally, the epididymal cyst may continue to increase in size or cause pain, swelling, or embarrassment in the patient.

In these cases, there are several treatment options.


If you and your urologist decide that you need to remove the epididymal cyst, surgery is the most common treatment. During the procedure, you will be placed under general anesthesia to help you fall asleep. But sometimes your doctor may decide to give you spinal anesthesia. This will make you wake up, but completely numb below the waist.

Then surgeons make an incision in the scrotum. They then remove the cyst from the epididymis and testicles, while maintaining the blood supply to the epididymis. They then suture the scrotum with absorbable sutures. To protect against infection, your doctor may prescribe antibiotics before the procedure begins.

For a few days after the procedure, patients may experience swelling and bruising. There is a possibility that the epididymal cyst will grow back. But the risk of this happening is lower with surgery than with other treatments for epididymal cysts.

In some cases, the removal of an epididymal cyst or a spermatocele can affect male fertility . This can cause a blockage of the epididymis or damage to the vas deferens , which carry sperm from the testicle to the urethra of the penis. This prevents the release of sperm.

It is important to discuss all possible side effects with a urologist prior to the procedure so that you are aware of your own risks. Then you can make the best decisions based on your age and the life decisions you consider.


This removal method involves inserting a needle into the cyst to drain it. This removes fluid build-up. Health professionals do not usually recommend this method, as the fluid is very likely to return quickly.

Percutaneous sclerotherapy

In some cases where the epididymal cyst continues to grow after aspiration, your doctor may recommend surgery. A less invasive procedure called percutaneous sclerotherapy is another option if the patient is unable or unwilling to undergo surgery.

This is an outpatient procedure. The surgeon uses ultrasound to insert a catheter (tube) into the cyst. A contrast dye is injected through a catheter into the cyst. This allows healthcare professionals to see the cyst more clearly. It also helps them see if a cyst is leaking or affects other parts of the testicle.

A liquid (usually ethanol, which helps kill the cyst cells) is injected through a catheter into the cyst for about 20 minutes.

The patient can be moved to different positions so that the fluid enters the entire cyst. Then the fluid is suctioned out of the cyst.

After the procedure, the patient usually sees the doctor a few months later. If the epididymal cyst does not shrink or disappear, your doctor may recommend a second sclerotherapy procedure.


Sometimes your healthcare provider may recommend percutaneous sclerotherapy instead of surgery. This is a less invasive procedure in which a catheter is used to inject contrast medium into the cyst. The surgeon removes fluid from the cyst. If the cyst doesn't shrink or go away, your doctor may suggest another sclerotherapy procedure.


An epididymal cyst is a fluid-filled lump in the testicle that is not cancerous. They develop in a coiled tube at the back of the testicle and become common as you age. Most epididymal cysts go away on their own. However, you should see your doctor to make sure the cyst is not cancer.

A doctor only treats cysts if they cause pain, discomfort, or embarrassment. Common treatments include surgery, aspiration, or percutaneous sclerotherapy.

Get the word of drug information

Finding a testicular lump can be a concern, but epididymal cysts are common and there is nothing to worry about. It is important to check your testicles monthly for any lumps. In this way, you will be aware of any cysts or growths you may have and how their size changes over time.

All neoplasms should be examined by a doctor, even if you think it is an epididymal cyst. This will rule out a more serious illness.

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