What Is an Epididymal Cyst and Is It Serious?

Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes

Diagnosis

Treatment

Frequently Asked Questions

Anepididymalcyst is a fluid-filled pocket that forms in theepididymis, a coiled tube in the back of thetesticlethat stores and transports sperm.These cysts are benign (not cancerous), typically painless, and can be very common with age. They do not affect fertility.

This article will discuss epididymal cysts, including what causes them. It also addressed their symptoms and how they’re diagnosed and treated.

Epididymal Cyst vs. Spermatocele

What Are the Symptoms of Epididymal Cysts?

There are usually no symptoms that warn that an epididymal cyst is forming. Once one is present, you may notice a ball behind, above, or below one of your testicles, as well as:

Males are most likely to develop these cysts when they are middle-aged, and it’s rare for them to affect both rather than one testicle.Epididymal cysts are a rare finding in children but they can occur.

An epididymal cyst usually won’t cause sharp, intense pain or hurt when squeezed, and typically is painless altogether. But if any of the above symptoms occur, you should see a urologist for a complete checkup.

Epididymal Cysts in KidsA study of 4,508 ultrasounds of the scrotum in male children found epididymal cysts in 109 cases that did not involve a history of tumors, cystic fibrosis, or other causes. Nearly half (47%) were found in kids ages 2 or younger, and 14% were then identified in males between ages 2 and 10. The remainder were found in older children.

Epididymal Cysts in Kids

A study of 4,508 ultrasounds of the scrotum in male children found epididymal cysts in 109 cases that did not involve a history of tumors, cystic fibrosis, or other causes. Nearly half (47%) were found in kids ages 2 or younger, and 14% were then identified in males between ages 2 and 10. The remainder were found in older children.

Possible Causes of Testicle Pain

What Causes Epididymal Cysts?

Experts don’t know what causes testicular cysts to form, but it’s possible that inflammation or a blockage of the epididymis may set the stage for them to develop.

Differential Diagnosis

A 2019 study identified a number of reasons why ultrasound tests were done for people with possible epididymal cysts. These conditions included:

Inflammation may be a cause of epididymal cysts, but like injury, it can be a separate condition.

How Are Epididymal Cysts Diagnosed?

Testicular cysts are typically found during a self-exam of the testicles or during an exam at your healthcare provider’s office. To determine the cause, the healthcare provider will do a physical exam, which may include transillumination (shining a light behind each testicle).

Testicular cancer, for example, is the most common malignancy in younger men between the ages of 15 and 40. It is a painless mass without transilluminated light shining through.When the lump is an epididymal cyst or spermatocele, the light will be able to get through to the other side.

Your healthcare provider may also order a scrotal ultrasound.This test uses sound waves to look inside the scrotum. It can check the blood flow and show whether the mass is a cyst.

Conditions That Cause a Lump in the Testicle

How Are Epididymal Cysts Treated?

Most testicular cysts are treated only if they cause pain or discomfort.A healthcare provider may recommendover-the-counter pain relief, such as Tylenol (acetaminophen), to help stop epididymal cyst pain. Once diagnosed, you can do regular self-exams and follow up with your healthcare provider to monitor the cysts.

Usually, epididymal cysts and spermatoceles will either get smaller as the body reabsorbs fluid from the cyst or they will stay the same size. Sometimes, though, an epididymal cyst may continue to grow larger or cause pain, swelling, or embarrassment to the patient.

In these instances, there are a few options for treatment.

Surgery

An epididymal cyst removal is the most common treatment if you and your urologist decide your epididymal cyst needs to be removed. The size and associated symptoms may be a factor in whether surgery is needed.Some providers suggest surgery before a cyst is 0.8 centimeters in diameter.

You will be put under general anesthesia to fall asleep for the duration of the procedure. But sometimes a healthcare provider may decide to give you a spinal anesthetic. This will leave you awake but completely numb from the waist down.

Surgeons will then make an incision in the scrotum. Next, they will remove the cyst from the epididymis and testicle while keeping the blood supply to the epididymis. They then sew up the scrotum with dissolvable stitches. The healthcare provider may prescribe antibiotics before the procedure starts to protect against infection.

Microscopic surgeries are also available to treat epididymal cysts, with studies reporting fewer complications (like bleeding) and less chance of later recurrence.

With surgery, pain is likely after the anesthesia wears off within eight hours. Ice packs may help to relieve pain.You may have swelling and bruising for seven to 10 days after the procedure. Depending on the type of sutures, it may be three weeks before they dissolve on their own.

There is a chance the epididymal cyst will grow back. But there’s less of a risk of this happening with surgery than with some of the other treatments for epididymal cysts.

It’s important to discuss all possible side effects with your urologist before the procedure so you’re aware of your own personal risk. Then you can make the best choice based on your age and any life decisions you may be considering.

In some cases, removing an epididymal cyst or spermatocele can affectmale fertility. It may cause a blockage in the epididymis or damage thevas deferens, which carries sperm from the testicle to the urethra in the penis. This prevents the sperm from traveling out.

Aspiration

Percutaneous Sclerotherapy

In some cases, a less-invasive procedure calledpercutaneous sclerotherapyis an option if you can’t have surgery or do not want to. The outpatient procedure involves an injection used to kill the cells in the cyst, which are then removed with the fluid.

Note that sclerotherapy presents a fertility risk due to potential harm to the epididymis and is rarely used or recommended.

Summary

An epididymal cyst is a fluid-filled lump in the testicle that isn’t cancerous. They develop in the coiled tube in the back part of the testicle and are common when you grow older. Most epididymal cysts go away on their own. However, you should see your healthcare provider to make sure a cyst isn’t cancer.

The healthcare provider treats the cysts only if they cause pain, discomfort, or embarrassment. Common treatments include surgery, aspiration, or percutaneous sclerotherapy.

It’s important to check your testicles monthly to look for any lumps.That way, you’ll be aware of any cysts or masses you may have as well as how their size changes over time.

Frequently Asked QuestionsTesticular cysts often resolve on their own. However, it may take up to four years for the cyst to completely go away.Learn MoreIs It Normal for One Testicle To Be Bigger?Testicular cysts are usually not a concern. However, if you notice a lump in or near your testicle or have pain in the area, it’s best to get checked out to be sure it’s what you assume it is. Cysts are generally easy to identify with a physical exam and ultrasound.Learn MoreTesticle Pain Causes and Treatment

Testicular cysts often resolve on their own. However, it may take up to four years for the cyst to completely go away.Learn MoreIs It Normal for One Testicle To Be Bigger?

Testicular cysts often resolve on their own. However, it may take up to four years for the cyst to completely go away.

Learn MoreIs It Normal for One Testicle To Be Bigger?

Testicular cysts are usually not a concern. However, if you notice a lump in or near your testicle or have pain in the area, it’s best to get checked out to be sure it’s what you assume it is. Cysts are generally easy to identify with a physical exam and ultrasound.Learn MoreTesticle Pain Causes and Treatment

Testicular cysts are usually not a concern. However, if you notice a lump in or near your testicle or have pain in the area, it’s best to get checked out to be sure it’s what you assume it is. Cysts are generally easy to identify with a physical exam and ultrasound.

Learn MoreTesticle Pain Causes and Treatment

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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Urology Care Foundation.What Are Spermatoceles (Spermatic Cysts)?

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