What is an epididymal cyst?
An epididymal cyst or spermatocele is an accumulation of fluid in the epididymis caused by an obstruction in the flow of seminal fluid (= retention cyst). The accumulation of fluid causes the spermatic cord to expand. At the beginning the cyst is usually only about the size of a pinhead and can hardly be palpated during the physical examination.
However, depending on the extent of the obstruction, the cyst may grow due to the increasing accumulation of fluid. If only one epididymis is affected, spermatocele usually does not lead to infertility. Therapy is therefore not urgently indicated and is usually carried out on the basis of patient wishes. However, a detailed diagnosis must be made in each case to exclude possible differential diagnoses, such as a testicular tumor.
What are the causes of epididymal cysts?
The cause of epididymal cysts is a downstream outflow disorder of the seminal fluid due to a constriction of the spermatic cord. As a result, more fluid is retained, which builds up pressure and ultimately causes the spermatic cord to bulge. This bulging can grow in the course of time.
One reason for constriction of the spermatic cord can be adhesions after inflammatory processes, for example as a result of infectious diseases. It is also possible, however, that the spermatic cord is compressed by an enlarged prostate or tumors. Furthermore, spermatozoa can occur after vasectomy, i.e. the cutting of the spermatic duct. Not infrequently, however, epididymal cysts are also congenital.
By which symptoms do I recognize an epididymal cyst?
In most cases, epididymal cysts do not cause symptoms such as infertility or pain. However, as the size increases, compression of surrounding structures may occur. Often affected persons feel the space requirement themselves and present themselves to the doctor to exclude possible other causes, such as a testicular tumor. Due to the asymptomatic nature of this finding, it can usually be easily distinguished from other diagnoses
