An epididymal cyst is a benign, fluid-filled sac that forms within the epididymis, a coiled tube located behind the testicle. While these cysts are generally harmless and some may remain small and unnoticed, they typically do not spontaneously resolve or disappear entirely once they have formed.
Understanding Epididymal Cysts
Epididymal cysts are sacs that develop in the epididymis, a long, coiled tube situated along the back of each testicle. This structure plays a crucial role in storing and transporting sperm. The cysts are typically fluid-filled and non-cancerous.
They generally present as a smooth, round, or oval lump located above or behind the testicle. They are often painless and can vary in size, from a few millimeters to several centimeters in diameter. Epididymal cysts are a relatively common condition, affecting individuals of all ages.
Natural Course and Resolution
Once an epididymal cyst develops, it typically does not spontaneously resolve or vanish on its own. These benign sacs tend to remain stable in size over time, though some may exhibit slow, gradual growth. The stability of these cysts means that observation is often the primary initial approach for management. Healthcare professionals typically monitor the cyst’s size and any associated symptoms during routine check-ups.
When to Seek Medical Advice
Consulting a healthcare professional is advisable if a new scrotal lump is discovered or if an existing lump changes. Specific symptoms that warrant medical attention include pain, discomfort, or a noticeable increase in the cyst’s size. Redness, tenderness, or any changes in the lump’s texture or location also necessitate prompt evaluation. The diagnostic process typically begins with a physical examination. Often, an ultrasound scan of the scrotum is performed to confirm the diagnosis, differentiate the lump from other conditions, and visualize its internal characteristics.
Treatment Approaches
For epididymal cysts that do not cause any symptoms, observation, also known as watchful waiting, is the standard approach.
If an epididymal cyst becomes symptomatic, causing pain, discomfort, or significant size, treatment options become necessary. Conservative measures, such as over-the-counter pain relievers, can help manage mild discomfort. For more persistent or severe symptoms, surgical intervention is considered.
Surgical options primarily involve cyst excision. In some cases, a procedure called an epididymectomy, involving the removal of the epididymis, might be performed, though this is less common for isolated cysts. Surgery is typically reserved for cases where the cyst causes considerable distress or is notably large.
Distinguishing from Other Scrotal Lumps
Epididymal cysts must be differentiated from other common scrotal masses, such as hydroceles, which are fluid collections surrounding the testicle. Spermatoceles are another type of cyst, often containing sperm, and can be difficult to distinguish from epididymal cysts without specific medical evaluation. Any new or changing scrotal mass must be evaluated by a medical professional to rule out more serious conditions, including testicular cancer. Testicular cancer often presents as a firm, painless lump within the testicle itself, rather than in the epididymis.