Spermatocele – everything you need to know

Worried you’ve got a spermatocele? If you find a lump in your balls, it’s understandable to feel concerned. Especially if you fall down a Google hole and only hear the worst. The truth is that a spermatocele is generally nothing to worry about – but it’s helpful to understand exactly what it is and how it can be treated, so you can put your mind at ease.

Here we’ll explain exactly what a spermatocele is and how it differs from more sinister lumps and bumps in your junk. 

So, what is a spermatocele? 

A spermatocele is a cyst that develops in the epididymis – a coiled tube behind each testicle that collects and transports sperm. This is a pretty common condition, affecting about 30% of men. For most people, a spermatocele won’t cause any pain, discomfort or complications.

What are the causes?

We know that a spermatocele is a blockage in the tubes that transport sperm, but we don’t yet know what causes this. This means there’s nothing you can do to prevent a spermatocele, but also means there’s no sense in dwelling on the possibility of it happening. 

What are the symptoms? 

Spermatoceles are generally painless so they can easily go unnoticed. They also can’t be seen during a visual exam because they’re contained within the scrotum, but they can be felt. 

A spermatocele will feel like a smooth, firm lump near the top of or behind the testicle. The mass is in the scrotum, not the testicles so don’t worry, it isn’t a sign of testicular cancer.

How do I check my testicles effectively?

It’s always good to check in with your testicular health, as testicular cancer is the most common type of cancer among 20-40 years old men. 

Our article “How To Self-Examine Your Testicles” will guide you through how to check yourself, and what to look out for. You should perform a self-check once a month, this way you’re less likely to miss any changes. If you feel a firm lump near the testicle, then it may be a spermatocele.

Your doctor can typically use a physical examination to diagnose a spermatocele. They can also perform a transillumination by passing a light through the scrotum so they can clearly examine the system to make sure it is a spermatocele.

How can I tell whether it’s a spermatocele or cancer? 

Feeling any kind of hard lump where it shouldn’t be is always a shock. Feeling one on your scrotum may be a bigger scare. 

The big difference between a spermatocele and testicular cancer is that a spermatocele isn’t on the testicle, but in the scrotum and the cords and veins going to your testis. A testicular tumour will generally appear as a hard lump on the testis.

Checking your balls regularly can help you notice the difference, but it’s impossible to give yourself a reliable diagnosis. It may be tempting to feel something unusual, Google it and brush it off as a harmless cyst. But that can lead to really dangerous consequences. Lumps on or around the testes may be harmless cysts, but they could also be symptoms of mumps, chlamydia, cancer, or hernia. Therefore, they can’t be ignored and the only way to really tell the difference is with a medical check – so be sure to give your doctor a call.

How can you get rid of a spermatocele? 

For most people, a spermatocele won’t cause any pain, discomfort, or complications, so there’s no need to get rid of it. Instead, your doctor will just monitor it regularly and ask you to do the same.

If a spermatocele becomes too large and potentially painful, then treatment may be necessary. Since there’s still much to be done for spermatocele treatment and research, the options are limited:

Medical therapy. You can take oral medication such as aspirin to help reduce pain and swelling, however there isn’t any medication specifically for spermatocele.

Minimally invasive therapy. There are two options your doctor may take to reduce or remove the spermatocele:

Aspiration. The doctor takes a needle, punctures the spermatocele and drains the fluid.

Sclerotherapy. The doctor injects an irritating agent into the cyst. This promotes healing and discourages the fluid from accumulating again.

Now, both these options can work but they’re generally not performed. This is because there’s a risk of damaging the tube – the epididymis – which would lead to more severe fertility complications. It’s also quite common for spermatocele to come back after this procedure, so it isn’t a guaranteed fix.

The final option is surgical therapy. This would be a spermatocelectomy, and is only necessary for symptomatic cases of spermatocele. A spermatocelectomy is done to remove the cyst while keeping the genitals intact and unharmed, and it can be performed in under an hour. 

However, there are cases where the epididymis will be partially or entirely removed during a spermatocele, which may cause infertility.

Can a spermatocele cause infertility? 

Now, in case you’re deeply worried after reading through that, the good news is that a spermatocele isn’t known to cause infertility. It is usually a totally symptomless condition which won’t cause you any difficulty.

The risk of infertility comes with the treatments, not the cyst itself. This doesn’t mean it’s worth ignoring swelling or pain, but if you’re looking at the possibility of needing medical treatment, talk through fertility with your doctor. If there’s a risk of becoming infertile after a necessary treatment, you can always freeze your swimmers for the future!

So, spermatocele? Not something to spend too much time worrying about. It’s very common, and rarely develops into a bigger issue. Remember to give yourself monthly checks and report any suspicious changes to your doctor. Your body can be pretty good at letting you know when something is wrong, so be sure to listen to it.