Spermatocele Epididymis cyst

The epididymis consists of a long and coiled tubular structure, located posteriorly to each testicle, also involving it in its upper and lower side. Its function is to collect and transport the sperm from the testis to the vas deferens, which subsequently conducts the semen to the urethra.

An epididymis cyst corresponds to a mass of soft consistency and liquid content at the level of the epididymis. It can also be called Spermatocele or Spermatic Cyst.

The causes that lead to its formation are not absolutely clear, being assumed that they are due to the blockage of one of the tubules that carry sperm.

In most cases, these lesions cause no symptoms and remain dimensionally stable, being detected by testicular self-palpation, during routine examination carried out by a physician or even in complementary diagnostic tests performed for other purposes.

However, when the volume increases, it may cause pain or discomfort on the side of the affected testicle or a feeling of heaviness or congestion in the surrounding region.

The diagnosis of this type of pathology is based on the medical examination, in which scrotal palpation is performed with the possible use of transillumination, depending on the volume, and can be complemented with scrotal ultrasound, which allows its differential diagnosis with high reliability.

Specialized evaluation of any scrotal mass is desirable, in order to exclude serious pathologies, namely, testicular tumor. The same is advised in case of pain or an increase in scrotal volume, which can be caused by a multiplicity of pathologies, some of which require immediate treatment.

In situations where an epididymis cyst becomes painful or swells causing discomfort, there may be an indication for treatment by surgical removal. The risks inherent to epididymis cyst excision surgery are essentially related to the possibility of injury to the epididymis or the vas deferens, with possible repercussions on fertility. Another of the risks to be addressed, although infrequent, is the possibility of recurrence of the cystic lesion.

Alternative therapeutic strategies to surgical excision, such as aspiration or sclerotherapy, are currently rarely used. In these approaches, the liquid content of the cyst is aspirated with a needle, and an irritating chemical agent can be injected later, which will fill the space previously occupied by the aspirated liquid and promote healing. The risks of recurrence and persistence of symptoms are higher.