A spermatocele is a cyst on the epididymis, which is a tube in a man’s testicle that stores and carries sperm. This type of cyst is usually small and benign. It often contains a milky liquid, usually containing dead sperm. Most men who have a spermatocele will not require treatment, unless it becomes very large or uncomfortable. In this case, surgery to remove the spermatocele is often recommended.
Spermatoceles often cause no symptoms at first. They usually measure less than 0.5 inches (1.27 cm) and are often only felt during testicular self-exams or testicular cancer screening exams. If they grow larger, they may cause pain, swelling or a feeling of heaviness in the testicle.
To diagnose a spermatocele, a health-care provider will often perform a manual exam. He or she may also hold a light up to the scrotum to see if the mass being felt is filled with fluid or if it is solid. Light will generally pass through this type of fluid-filled cyst, but it usually will not pass through a solid mass, such as a hernia or cancerous tumor. The health-care provider may also recommend having a testicular ultrasound, which can also help show whether or not the mass is filled with fluid.
If a spermatocele grows large and/or causes symptoms, a health-care provider may recommend a surgery called a spermatocelectomy. In general, a spermatocelectomy involves cutting open the scrotum and removing the spermatocele cyst through the opening. As with most surgeries, there can be risks to this procedure. For a spermatocelectomy in particular, the risks commonly include infertility, bruising and pain.
Another less common spermatocele treatment is sclerotherapy. This procedure is usually done by making a small incision in the scrotum and inserting a needle into the cyst to remove the fluid. A chemical is usually injected into the empty cyst sac. This chemical usually helps scar tissue grow inside the sac, which may help prevent the sac from filling up with fluid again. There may also be risks associated with this procedure, such as infertility, bleeding and infection.
Since spermatoceles don't usually cause problems and the procedures to remove them can have serious risks, many health-care providers suggest just keeping an eye on them until treatment becomes necessary. Regular self-exams and checkups with a health-care provider can help detect any changes in the spermatocele. They can also often help detect any other masses that may require attention.