Spermatocele is a retentioncyst of a tubule of the rete testis or the head of the epididymis distended with a milky fluid that contains spermatozoa. Spermatocele are the most common cystic condition encountered within the scrotum. They vary in size from several millimeters to many centimeters. Spermatocele are generally not painful. However, some men may experience discomfort from larger spermatoceles.
Spermatoceles can originate as diverticulum from the tubules found in the head of the epididymis. Sperm formation gradually causes the diverticulum to increase in size, causing a spermatocele.
They are also believed to result from epididymitis or physical trauma. Scarring, of any part of the epididymis, can cause it to become obstructed and may form a spermatocele.
Diagnosis
Spermatoceles are can be discovered as incidental scrotal masses found on physical examination by a physician. They may also be discovered by self-inspection of the scrotum and testicles.
Finding a painless, cystic mass at the head of the epididymis, that transilluminates and can be clearly differentiated from the testicle, is generally sufficient. If uncertainty exists, ultrasonography of the scrotum can confirm if it is spermatocele.
Small cysts are best left alone, as are larger cysts that are asymptomatic. Only when the cysts are causing discomfort and are enlarging in size, or the patient wants the spermatocele removed, should a spermatocelectomy be considered. Pain may persist even after removal.
Spermatocelectomy can be performed on an outpatient basis, with the use of local or general anesthesia.
Note: A spermatocelectomy will not improve fertility.
Spermatoceles typically arise from the caput (head) of the epididymis, which is located on the superior aspect of the testicle.
Because aspiration of spermatocele alone is associated with a high recurrence rate, a sclerosing agent is used to cause coaptation of the walls of the cyst.
Using both blunt and sharp dissection, the spermatocele is isolated from the body of the epididymis, and, typically, a narrow neck is found attaching the spermatocele to the rest of the epididymis.
Spermatoceles are benign cysts of the scrotum (from "spermato", for sperm, and "cele", for cavity)..
If the epididymis is removed with the spermatocele, the recurrence rate is lower, but then there is an slight increase in risk of damage to the blood supply to the testicle.
Hormone problems after spermatocele removal is a very unlikely event, and would only occur in the rare event that the blood supply to the testicle is damaged.
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