Overview

A spermatocele (SPUR-muh-toe-seel) is an abnormal sac (cyst) that develops in the epididymis — the small, coiled tube located on the upper testicle that collects and transports sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm.

The exact cause of spermatoceles isn't clear, but they might be due to a blockage in one of the tubes that transport sperm.

Spermatoceles, sometimes called spermatic cysts, are common. They typically don't reduce fertility or require treatment. If a spermatocele grows large enough to cause discomfort, your doctor might suggest surgery.

Symptoms

A spermatocele usually causes no signs or symptoms and might remain stable in size. If it becomes large enough, however, you might feel:

  • Pain or discomfort in the affected testicle
  • Heaviness in the testicle with the spermatocele
  • Fullness behind and above the testicle

When to see a doctor

Because a spermatocele usually doesn't cause symptoms, you might discover it only during a testicular self-exam, or your doctor might find it during a routine physical exam.

It's a good idea to have your doctor evaluate any scrotal mass to rule out a serious condition, such as testicular cancer. Also, call your doctor if you experience pain or swelling in your scrotum. A number of conditions can cause testicular pain, and some require immediate treatment.

Causes

The cause of spermatoceles is unknown. Spermatoceles might result from a blockage in one of the multiple tubes within the epididymis that transport and store sperm from the testicle.

Risk factors

There aren't many known risk factors for developing a spermatocele. Men whose mothers were given the drug diethylstilbestrol (DES) during pregnancy to prevent miscarriage and other pregnancy complications appear to have a higher risk of spermatoceles. Use of this drug was stopped in 1971 due to concerns about an increased risk of rare vaginal cancer in women.

Complications

A spermatocele is unlikely to cause complications.

However, if your spermatocele is painful or has grown so large that it's causing you discomfort, you might need to have surgery to remove the spermatocele. Surgical removal might damage the epididymis or the vas deferens, a tube that transports sperm from the epididymis to the penis. Damage to either can reduce fertility. Another possible complication that can occur after surgery is that the spermatocele might come back, though this is uncommon.

Prevention

Although there's no way to prevent a spermatocele, it's important for you to conduct scrotal self-exams at least monthly to detect changes, such as masses, in your scrotum. Any new mass in your scrotum should be evaluated promptly.

Your doctor can instruct you in how to conduct a testicular self-examination, which can improve your chances of finding a mass.

How to examine your testicles

A good time to examine your testicles is during or after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to detect anything unusual. Then follow these steps:

  • Stand in front of a mirror. Look for any swelling on the skin of the scrotum.
  • Examine each testicle with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.
  • Gently roll the testicle between the thumbs and the fingers. Remember that the testicles are usually smooth, oval shaped and somewhat firm. It's normal for one testicle to be slightly larger than the other. Also, the cord leading upward from the top of the testicle (epididymis) is a normal part of the scrotum.

By regularly performing this exam, you'll become more familiar with your testicles and aware of any changes that might be of concern. If you find a lump, call your doctor as soon as possible.

Regular self-examination is an important health habit. But it can't substitute for a doctor's examination. Your doctor normally checks your testicles whenever you have a physical exam.

Feb. 07, 2018
References
  1. AskMayoExpert. Scrotal mass. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  2. Spermatoceles (spermatic cyst). American Urological Association Foundation. http://www.urologyhealth.org/urology/index.cfm?article=117. Accessed Dec. 29, 2017.
  3. Shah VS, et al. Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit. Journal of Urology. 2014;192:1179.
  4. Eyre RC. Evaluation of nonacute scrotal pathology in adult men. https://www.uptodate.com/contents/search. Accessed Dec. 23, 2017.
  5. About DES. Centers for Disease Control and Prevention. https://www.cdc.gov/des/consumers/about/history.html. Accessed Dec. 23, 2017.
  6. Walls RM, et al., eds. Selected urologic disorders. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Dec. 23, 2017.
  7. Do I have testicular cancer? American Cancer Society. https://www.cancer.org/cancer/testicular-cancer/do-i-have-testicular-cancer.html. Accessed Dec. 29, 2017.