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Epididymal Cysts and Spermatoceles: Clinical Features and Treatment Options

Learn about the types, clinical features, and treatment of epididymal cysts and spermatoceles, including their characteristics, differential diagnosis, and management strategies such as aspiration and excision.

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Epididymal Cysts and Spermatoceles: Clinical Features and Treatment Options

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  1. Cysts connected with the epididymis

  2. Types • Cysts of the epididymis • Spermatocele

  3. Cysts of the epididymis • Congenital, derived from an embryonic remnant around the epididymis • Filled with crystal clear fluid

  4. Cysts of the epididymis: clinical features • Found during middle life • Usually bilateral • Cysts: • Located behind the body of the testis • Tense (aggregation of a number of small cysts like bunch of tiny grapes) • Fluctuation difficult appreciate • Transillumination: Chinese lantern pattern

  5. Cysts of the epididymis: D/D • Cysts of the appendages of the testis

  6. Cysts of the epididymis: T/t • If small no T/t is needed • Surgical if the cyst is large & causing discomfort • Aspiration is useless, as these cysts are usually multilocular

  7. Spermatocele • Acquired • Unilocular • Retention cyst • Cysts contain fluid resembling barley – water containing spermatozoa

  8. Spermatocele: clinical features • Scrotal swelling • Location: head of the epididymis, above & behind the body of testis • Testis can be felt separately from the body of the testis • Soft • Fluctuation: usually positive • Transillumination test: negative

  9. Testicle (grey) and Spermatocele (black)

  10. Spermatocele: T/t • Aspiration • Excision of the cyst

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