Epididymal Cysts: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Avinash Gottumukkala , Urologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Epididymal Cysts are benign, fluid-filled sacs that develop within the epididymis, the coiled tube located behind each testicle that stores and transports sperm. These cysts are common, usually painless, and often discovered incidentally during self-examination or a routine medical evaluation. While most epididymal cysts do not affect fertility or require treatment, larger cysts may cause discomfort, a feeling of heaviness, or scrotal swelling. Early diagnosis is important to distinguish epididymal cysts from other scrotal conditions and to determine whether observation or treatment is appropriate.

What are the Types Of Epididymal Cysts?

Spermatocele: Also known as a spermatic cyst, this type of epididymal cyst is filled with milky fluid that contains sperm. It may cause discomfort or swelling in the scrotum, but is typically benign and does not usually require treatment unless it becomes bothersome.
Hydrocele of the Epididymis: This type of cyst is characterized by the accumulation of fluid within the epididymis, leading to a painless swelling in the scrotum. It is usually harmless and may resolve on its own, but persistent cases may require medical evaluation.
Tubular Ectasia: Tubular ectasia is a condition in which the epididymal tubules become dilated, leading to cystic enlargement and, in some cases, a painless scrotal swelling.

What Are the Symptoms of Epididymal Cysts?

Epididymal cysts may not cause any symptoms in many cases. However, some men may experience pain or discomfort in the scrotum. Swelling or a lump in the testicle area can also be a sign of an epididymal cyst. If you notice any unusual changes in the scrotum, it is important to see a healthcare provider for evaluation and proper management.

Pain or discomfort in the scrotum, especially when sitting or during physical activity, can be a symptom of an epididymal cyst.
A small, firm lump or swelling near the testicle that may be painless but noticeable to the touch could indicate the presence of an epididymal cyst.
Feeling of heaviness or pressure in the scrotum that persists over time may be a sign of an epididymal cyst.
Enlargement or changes in the size of the cyst over time, leading to a visible bulge in the scrotum, can be a symptom to watch out for.

What are the Causes of Epididymal Cysts?

This blockage can lead to a buildup of fluid, creating a cyst. While the exact cause is often unknown, factors such as injury, infection, or inflammation of the epididymis may contribute to their formation. Generally benign, epididymal cysts are common and usually do not require treatment unless they cause discomfort.

Epididymal cysts can develop as a result of a blockage or obstruction in the epididymis, preventing the normal flow of fluid and leading to the formation of a cyst.
Inflammation or infection of the epididymis, known as epididymitis, can sometimes cause cysts to form in the epididymal tissue. Trauma or injury to the scrotum swelling or testicles may also contribute to the development of epididymal cysts as a response to the damage.
Congenital factors, such as abnormalities in the development of the epididymis or surrounding structures, could predispose individuals to developing cysts in this area.

When to See a Doctor for Epididymal Cysts?

Anyone who notices a new scrotal lump, persistent swelling, pain, or changes in the size of a known cyst should consult a Urologist for evaluation.

You should see a doctor if you experience:

A newly discovered lump in the scrotum
Increasing size of an existing cyst
Persistent scrotal discomfort or heaviness

Seek emergency medical attention immediately if you:

Develop sudden, severe testicular pain
Notice rapid swelling with redness and fever
Experience nausea and severe scrotal pain suggestive of testicular torsion

These symptoms may indicate a medical emergency requiring urgent treatment.

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How Are Epididymal Cysts Diagnosed?

During the exam, the healthcare provider will feel the scrotum to check for lumps or swelling. An ultrasound can confirm the presence of a cyst and help rule out other conditions. This process is painless and helps the doctor determine the best course of treatment.

Physical Examination: A healthcare provider can often detect an epididymal cyst through a physical examination by feeling a firm lump in the scrotum.
Ultrasound Imaging: An ultrasound scan can provide detailed images of the scrotum to confirm the presence of an epididymal cyst and rule out other conditions.
Transillumination: During this procedure, a light is shined through the scrotum to help differentiate between a fluid-filled cyst and other abnormalities.
Blood Tests: Blood tests may be conducted to check for any signs of infection or underlying medical conditions that could be causing the epididymal cyst.
Biopsy: In some cases, a biopsy may be performed to collect a sample.

What are the Treatment for Epididymal Cysts?

Treatment options for epididymal cysts may include observation, pain management, or surgical removal if necessary. Your healthcare provider will recommend the best option based on the size and symptoms of the cyst. Pain relief medications can help manage discomfort, while surgery may be considered if the cyst is causing significant issues. It's important to discuss the treatment plan with your doctor for personalized care.

Observation: In many cases, epididymal cysts are harmless and may not require treatment, with doctors often recommending a watchful waiting approach to monitor the cyst's size and any changes in symptoms over time.
Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate any discomfort associated with epididymal cysts, providing symptomatic relief while waiting for the cyst to resolve on its own.
Sclerotherapy: A minimally invasive procedure where a needle is used to drain the fluid from the cyst and then inject a sclerosing agent to help collapse the cyst walls, promoting its shrinkage and reducing the risk of recurrence.

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What are the Risk Factors of Epididymal Cysts?

Prior history of trauma or surgery in the genital area can increase the risk. Certain genetic conditions and underlying health issues, such as infections or inflammation disease, may also play a role in the development of epididymal cysts. Regular medical check-ups are important for early detection and management.

Age: Older men are at a higher risk of developing epididymal cysts compared to younger individuals.
Trauma: Previous injuries or trauma to the scrotum can increase the likelihood of developing epididymal cysts.
Infection: Infections in the epididymis or surrounding areas can lead to the formation of cysts.
Congenital Factors: Certain congenital conditions or abnormalities in the reproductive system may predispose individuals to epididymal cysts.
Surgical History: Men who have undergone previous surgeries in the scrotal area may have an increased risk of developing epididymal cysts.

What Is the Recovery Process for an Epididymal Cyst?

Recovery is generally simple, especially if no surgery is required, and focuses on symptom management.

Regular monitoring of cyst size and symptoms.
Following prescribed medications if needed.
Avoiding activities causing discomfort.
Post-surgical care if removal is performed.

Frequently Asked Questions

1. Are Epididymal Cysts cancerous?

No, Epididymal Cysts are benign (non-cancerous) and do not increase the risk of testicular cancer.

2. How are Epididymal Cysts treated?

Small, painless cysts usually do not require treatment and can be monitored. If a cyst becomes large or causes pain, treatment may include surgical removal. Aspiration is rarely used because the cyst may recur.

3. Can Epididymal Cysts affect fertility?

Most Epididymal Cysts do not affect fertility. However, very large cysts or surgery involving the epididymis may rarely affect sperm transport.

4. What complications can occur with Epididymal Cysts?

Complications are uncommon but may include increasing size, discomfort, pain, infection, or recurrence after treatment.

5. Can Epididymal Cysts be prevented?

There is no known way to prevent Epididymal Cysts. Regular testicular self-examinations can help detect new lumps early and ensure timely medical evaluation.