Spermatocele

Description

A spermatocele (SPUR-muh-toe-seel) is an abnormal sac (cyst) that develops in the epididymis — the small, coiled tube in the upper part of the testicle that collects and carries sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm.

The exact cause of spermatoceles is not clear, but could be due to a blockage in one of the tubes that carry sperm.

Spermatoceles, sometimes called the spermatic cysts, are common. In general, do not reduce fertility or require treatment. If a spermatocele grows large enough to cause discomfort, your doctor may suggest surgery.

Symptoms

A spermatocele usually causes no signs or symptoms, and may remain stable in size. If made large enough, however, you may feel:

  • Pain or discomfort in the affected testicle
  • The feeling of heaviness in the testicle with the spermatocele
  • Fullness behind and above the testis

When to see a doctor

Because a spermatocele usually doesn't cause symptoms, you might discover that only during a testicular self-exam, or your doctor may find it during a routine physical examination.

It is a good idea to have your doctor evaluate any scrotal mass to rule out a serious illness, such as cancer of the testicle. Also, call your doctor if you experience pain or swelling in the scrotum. A number of conditions can cause testicular pain, and some require immediate treatment.

Causes

The cause of spermatoceles is unknown. Spermatoceles may be the result of a blockage in one of the multiple tubes within the epididymis that transport and store sperm from the testicle.

Risk factors

There are not many well-known risk factors for the development of a spermatocele. Men whose mothers received the drug diethylstilbestrol (DES) during pregnancy to prevent miscarriage and other pregnancy complications appear to have a greater risk of spermatoceles. The use of this drug was stopped in 1971 due to concerns about an increase in the risk of a rare vaginal cancer in women.

Complications

A spermatocele is unlikely to cause complications.

However, if your spermatocele is painful or that it has grown so large that it is causing you discomfort, you may need surgery to remove the spermatocele. The surgical removal may damage the epididymis or the vas deferens, a tube that carries sperm from the epididymis to the penis. The damage that can reduce fertility. Another possible complication that may occur after the surgery is that the spermatocele could return, although this is uncommon.

Prevention

Although there is no way to prevent a spermatocele, it is important for you to perform scrotal self-exams at least monthly to detect changes, such as the masses, in his scrotum. Any new mass in his scrotum should be evaluated promptly.

Your doctor can tell you how to perform a testicular self-examination, which can improve your chances of finding a mass.

How to examine your testicles

A good time to examine your testicles is during or after a hot bath or shower. The heat of the water relaxes the scrotum, making it easier for you to spot anything unusual. Then, follow these steps:

  • Stand in front of a mirror. Look for any swelling on the skin of the scrotum.
  • Browse each one of the testes with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.
  • Gently roll the testicle between the thumb and fingers. Remember that the testicles are usually smooth, oval-shaped, and something firm. It is normal for one testicle to be slightly larger than the other. In addition, the cable that leads upward from the top of the testicle (epididymis) is a normal part of the scrotum.

Regularly performing this test, you will become more familiar with your testicles and aware of the changes that might be of interest to you. If you find a lump, call your doctor as soon as possible.

The self-examination is an important habit of health. But you can not replace a doctor's examination. Your doctor checks normally the testicles when you have a physical exam.

Spermatocele

Diagnosis

To diagnose a spermatocele, you will need a physical exam. Although a spermatocele usually is not painful, you may feel discomfort when the doctor examines (palpa) the mass.

You can also undergo the following diagnostic tests:

  • The transillumination. Your doctor may shine a light through his scrotum. With a spermatocele, the light indicate that the mass is fluid-filled rather than solid.
  • Ultrasound. If transillumination does not clearly indicate the presence of a cyst, an ultrasound can help determine what else it could be. This test, which uses high-frequency sound waves to create images of the structures, can be used to rule out testicular tumor, or another cause of scrotal swelling.

Treatment

Despite his spermatocele is probably not going to go away on its own account, the majority of spermatoceles do not need treatment. They generally do not cause pain or complications. If yours is painful, your doctor may recommend over-the-counter pain medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Surgical treatment

A procedure called a spermatocelectomy is usually done on an outpatient basis using a general or local anesthetic. The surgeon makes an incision in the scrotum, and separates the spermatocele from the epididymis.

After the surgery, you may need to use a gauze-filled, athletic supporter, apply pressure to protect the incision site. Your doctor may tell you to:

  • Apply ice packs during two or three days to prevent swelling
  • Taking pain medications for a day or two
  • Return for a follow-up examination between one and three weeks after the surgery

Possible complications of surgical removal, which could affect fertility include damage to the epididymis or the tube that carries the sperm (vas deferens). It is also possible that a spermatocele could come back, even after surgery.

Aspiration with or without sclerotherapy

Other treatments include aspiration and sclerotherapy, although they are rarely used. During the aspiration, a special needle is inserted into the spermatocele, and the fluid is removed (aspirated).

If the spermatocele is repeated, your doctor may recommend aspirating the liquid again, and then the injection of an irritant chemical in the sac (sclerotherapy). The irritant causes the spermatocele sack of the scar, which occupies the space of the fluid occupied and reduces the risk of the spermatocele back.

Damage to the epididymis is one of the possible complications of sclerotherapy. It is also possible that your spermatocele could return.

The protection of your fertility

The surgery can potentially cause damage to the epididymis or vas deferens, and sclerotherapy may damage the epididymis, which can affect fertility. Due to this concern, these procedures can be delayed until you are finished having children. If the spermatocele is the cause of so much pain that one does not want to wait, talk with your doctor about the risks and benefits of a sperm bank.

Preparing for your appointment

It is likely to start by seeing your family doctor or a general practitioner. However, you may be referred to a doctor who specializes in the treatment of the urinary tract and sex organs in men (urologist).

Because appointments can be brief, and often there is a lot to remember, that it is a good idea to get well prepared. Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any testicular injury.
  • Write questions to ask their doctor.

Your time with your doctor is often limited, so preparing a list of questions can help you make the most of their time together. For spermatocele, some basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need? Do these tests require any special preparation?
  • Is this condition temporary or long-term?
  • Is spermatocele affect my ability to have sex?
  • Will this condition affect my fertility?
  • I need treatment?
  • What treatments are available, and which do you recommend?
  • What types of side effects can I expect from treatment?
  • How long after the surgery, I will have to wait before returning to your normal activities?
  • How long after the surgery, I will have to wait before resuming sexual activity?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • What types of symptoms that you are experiencing?
  • How often do you have symptoms?
  • How long did your symptoms start?
  • How severe are the symptoms?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has had some trauma to the scrotal area?

What you can do in the meantime

If the spermatocele is causing the pain, the majority of the people can take over-the-counter pain medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) to relieve the discomfort.

Symptoms and treatment of Spermatocele