Spermatocele

A spermatocele is a benign cystic dilatation arising from the epididymal ducts, typically within the epididymal head.

The fluid commonly contains sperm.

It is benign and does not transform into testicular cancer.

Usually presents as:

• Painless superior scrotal swelling
• Soft fluctuant mass
• Sense of heaviness when large

The testis should remain independently palpable.

Scrotal ultrasound demonstrates an extratesticular epididymal cystic lesion.

Internal echoes can occur because of sperm and proteinaceous fluid.

Observe asymptomatic lesions.

Spermatocelectomy is appropriate for persistent:

• Pain
• Large size
• Mechanical discomfort
• Cosmetic concern

Dissect the cyst carefully from the epididymal tissue.

Men wishing future fertility should understand that surgery can damage:

• Epididymal ducts
• Vas related drainage

and occasionally impair fertility.