Up to one third of men will have a common condition causing a small, painless lump in the scrotum called a spermatocele. A spermatocele is a benign cyst in which there is an accumulation of sperm that comes from the head of the epididymis.  It may also be referred to as an epididymal cyst as it is found within the long, tightly coiled tube called the epididymis that lies above and behind each testicle.  If a man notices or feels this lump, it will usually feel like a smooth, firm lump in the scrotum on top of the testicle.  A spermatocele mass is not cancerous and do not increase the risk of testicular cancer.  Fortunately, with appropriate urological care, a spermatocele can be managed effectively for most men. 

Causes of spermatocele

It is not known what the exact cause of a spermatocele may be but it could be arise from a blockage or obstruction of the tubes – epididymal ducts – that carry sperm from the testicles.  There is also the possibility it could develop due to an injury or swelling on the skin.

Symptoms of spermatocele

Generally, a man may have no symptoms associated with a spermatocele.  Occasionally there may be some painful sensations but mainly when the spermatocele size becomes too large.  A man most likely will notice what looks or feels like an extra lump or mass above the testicle on one side of the scrotum or an overall enlargement of the scrotum.  Other symptoms, if present, might include pain, swelling, or redness of the scrotum of a feeling of pressure at the base of the penis. 

Diagnosis of a spermatocele

To diagnosis if a man has a spermatocele, a doctor will need to examine the scrotum.  One method of diagnosis is that the doctor may shine a light behind each testicle looking for a solid mass that could indicate possible cancer of the testicle.  Since spermatoceles are filled with fluid, light will shine right through them whereas light will not pass through a solid mass.  The use of an ultrasound is another method to help confirm the diagnosis of a spermatocele.

Treating a spermatocele

If a man is having no discomfort or pain and the spermatocele is small and does not become larger, then no treatment is necessary.  Small spermatoceles may be present for years and never cause problems.  It is possible that the body will reabsorb the fluid within a spermatocele to where it becomes smaller.  Spermatocele are not a dangerous condition and generally are only treated if the lump becomes too large and is causing much discomfort. 

If a man is having some mild discomfort such as pain in the testicles, then over-the-counter medications can be given to relieve the pain.

Spermatocele’s that become too large should be removed.  To do this a spermatocelectomy is where a doctor will surgically separate the spermatocele from the epididymis.  The main side effects of this procedure is pain after surgery and the possibility of bruising and even infertility.