An epididymal cyst is a fluid-filled pocket that forms in the epididymis, a coiled tube in the back of the testicle that stores and transports sperm.1 These cysts are benign (not cancerous), typically painless, and can be very common with age. They do not affect fertility.2
Often, there are no signs an epididymal cyst is forming. But once one has, you may notice a small, water balloon-like mass and experience tenderness and swelling of the testicle, as well as other symptoms.
Epididymal cysts usually don't require treatment, but it's important to have any growths examined by a healthcare provider just in case something more serious may be at play, such as a tumor or hernia.
This article will discuss epididymal cysts, including what causes them, their symptoms, and how they're diagnosed and treated.
There are usually no symptoms that warn that an epididymal cyst is forming. Once one is present, you may notice a ball behind, above, or below one of your testicles, as well as:2
Dull pain in the scrotum (the sack that holds the testicles)
A feeling of heaviness in the scrotum
Redness in the scrotum
Feeling of pressure at the bottom of the penis
Tenderness or swelling at the back of the testicle
Tenderness, swelling, or hardening of the testicle itself
Pain in the groin or lower back and abdomen
Epididymal cysts usually don’t cause sharp, intense pain. Most of the time, they are completely painless.
If any of the above symptoms occur, you should go see a urologist for a complete checkup.
Treatment of Epididymal Cysts
Most testicular cysts are treated only if they cause pain or discomfort.4 Once diagnosed, you can do regular self-exams and follow up with your healthcare provider to monitor the cysts.
Usually, epididymal cysts and spermatoceles will either get smaller as the body reabsorbs fluid from the cyst or they will stay the same size. Sometimes, though, an epididymal cyst may continue to grow larger or cause pain, swelling, or embarrassment to the patient.
In these instances, there are a few options for treatment.
Testicular cysts are typically found during a self-exam of the testicles or during an exam at your healthcare provider's office. To determine the cause, the healthcare provider will do a physical exam, which may include shining a light behind each testicle.
Using a light will help the healthcare provider determine if there are any masses such as a tumor blocking the light from shining through. When the lump is an epididymal cyst or spermatocele, the light will be able to get through to the other side.
Your healthcare provider may also order a scrotal ultrasound.3 This test uses sound waves to look inside the scrotum. It can check the blood flow and show whether the mass is a cyst or something more serious.
It's not possible to tell whether cyst is an epididymal cyst or spermatocele with just a physical exam or ultrasound, however. That's why healthcare providers often refer to them by both terms.
After determining the cause of the lump, your healthcare provider will probably send you to a urologist to track its growth over time and manage any symptoms that may be associated with it.
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