Understanding Epididymal Cysts
Epididymal cysts are the emergence of non-cancerous soft lumps on the epididymis. The epididymis is a duct in the male reproductive system that functions as a storage place for sperm before ejaculation, during intimacy, and as a site for sperm maturation. Cyst lumps are generally benign and harmless.
Causes of Epididymal Cysts
The exact causes are generally unknown. However, experts speculate that this condition occurs due to blockages in the epididymis that carry sperm from the testes. Epididymal cysts can also occur due to congenital abnormalities associated with hormonal disturbances during fetal development.
Risk Factors of Epididymal Cysts
Generally, these cysts occur in adult men around the age of 40. Other risk factors include exposure to molecules that can disrupt hormones (such as diethylstilbestrol) occurring in pregnant mothers during fetal development and formation.
Moreover, epididymal cysts can also be part of testicular dysgenesis syndrome, which consists of four conditions: undescended testicles (cryptorchidism), urethral opening not at the tip of the penis but below it (hypospadias), spermatogenesis disorders (sperm formation), and testicular cancer resulting from developmental disorders in the fetus’s testes.
Symptoms of Epididymal Cysts
Common symptoms of epididymal cysts include:
- Presence of pain. However, pain may also be absent in some individuals.
- The cyst feels like a smooth and firm lump on one side or the entire scrotum above the testicles.
- Swelling and redness in the scrotum or a feeling of pressure at the base of the penis.
Diagnosis of Epididymal Cysts
The diagnosis of epididymal cysts is made through physical examination, such as transillumination testing. This test involves shining a light onto the lump. The aim is to see if the lump contains fluid or solid mass. Epididymal cysts will appear bright when illuminated with the light.
Moreover, epididymal cysts are almost always palpable as multiple lumps. Supplementary tests such as ultrasound may be necessary to confirm the diagnosis or determine if the lump contains solid or fluid mass.
Treatment of Epididymal Cysts
Epididymal cysts that occur without accompanying symptoms generally do not require specific treatment. Surgical procedures are required if there are bothersome symptoms or if the cyst size increases. The surgical procedure, called spermatocelectomy, is usually performed on an outpatient basis using local or general anesthesia.
Spermatocelectomy involves making an incision in the scrotum and separating the spermatocele from the epididymis. Surgery may carry risks such as damage that obstructs sperm flow, affecting fertility. Unfortunately, recurrence can still occur despite undergoing surgery.
Another treatment option is aspiration and sclerotherapy, but these are rarely used. Aspiration involves inserting a special needle into the spermatocele to aspirate and remove the fluid. If the spermatocele reappears, the doctor may recommend aspirating the fluid again and injecting a chemical into the sac (sclerotherapy).
The irritant substance will cause the spermatocele sac to scar, occupying the space occupied by the fluid and reducing the risk of recurrence. Complications of sclerotherapy include damage to the epididymis.
Complications of Epididymal Cysts
Epididymal cysts are rarely associated with health complications. However, spermatocelectomy surgery increases the risk of damage to the epididymis and vas deferens, the tubes responsible for transporting sperm from the epididymis to the penis. This condition can lead to decreased fertility levels in sufferers.
Prevention of Epididymal Cysts
There is no way to prevent epididymal cysts. However, it is advisable to perform routine self-examinations of the scrotum to detect any lumps in that area.
