What are epididymal cysts?
Epididymal cysts are fluid-filled sacs that develop in the epididymis, the coiled tube located behind each testicle responsible for storing and transporting sperm. These cysts are typically benign and non-cancerous. While the term “cyst” can sound concerning, epididymal cysts are usually harmless and do not interfere with fertility or normal reproductive function.
They often cause no symptoms and may go unnoticed for a long time. When symptoms do occur, they usually involve a painless swelling or lump in the scrotum. The size of the cysts can vary, and larger ones may cause discomfort, a sensation of heaviness, or even mild pain.
If pain, discomfort, or noticeable swelling develops, it is advisable to see a healthcare professional. They can assess the situation and determine whether treatment is necessary.
Causes and prevalence of epididymal cysts
Epididymal cysts are standard, especially in men over the age of 40. Many men may have them without knowing, since they frequently cause no symptoms. They are less commonly seen in children, although small cysts can occasionally be found in younger individuals. The exact cause is not fully understood, but it is believed that minor injuries, blockages, or inflammation within the epididymis may contribute to their development.
Regular awareness and testicular self-examinations can help detect changes early, allowing for timely medical advice if needed.
When should epididymal cysts be surgically removed?
Most epididymal cysts do not require any treatment and can be safely left alone. However, if a cyst grows large enough to cause significant pain, discomfort, or interfere with daily activities, surgical removal may be recommended. Surgery may also be an option if the cyst becomes large enough to cause visible changes or leads to emotional discomfort.
The decision to proceed with surgery depends on how much the cyst affects your quality of life. A healthcare professional will assess your symptoms and help you understand whether surgery is necessary, balancing the potential benefits with any associated risks. In some cases, continued observation and conservative management may be a better option.
Alternatives to surgical removal
When surgery is not immediately needed, other options can be considered. Conservative management typically involves monitoring the cyst over time and using pain relief medication if necessary. This approach is practical for small cysts that are not causing significant symptoms.
Another option is needle aspiration, in which a doctor uses a thin needle to drain fluid from the cyst. This can temporarily relieve pressure or discomfort, but cysts often refill, and the procedure can sometimes be uncomfortable. A less commonly used method, percutaneous sclerotherapy, involves injecting a chemical substance into the cyst to shrink it by destroying the cyst lining. Although this can be effective, it carries a small risk of affecting nearby tissues and potentially impacting fertility.
Each treatment approach has its advantages and drawbacks, and discussing your options with a specialist is the best way to determine what is most appropriate for your circumstances.
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Ways to payBefore surgery
Initial consultation
During your initial consultation, your doctor will take a detailed history of your symptoms and perform a physical examination of the scrotum and testicles to assess the size and position of the cyst. Imaging, such as an ultrasound scan, is usually ordered to confirm the diagnosis and to rule out any other conditions, such as testicular cancer.
This consultation is also the time to ask any questions you may have. Your doctor will explain the benefits and potential risks of surgery, discuss non-surgical alternatives, and review any medications you’re currently taking. Some medicines may need to be paused before the procedure. You should also arrange for someone to take you home afterwards, as you will not be able to drive due to the effects of the anaesthesia.
By the end of this appointment, you and your doctor should have an informed treatment plan.
During surgery
Epididymal cyst removal surgery is performed under general anaesthesia, meaning you will be asleep and pain-free throughout the procedure. The surgeon makes a small incision in the scrotum to access the cyst. The cyst is then carefully separated from the surrounding tissue and removed, with special care taken to preserve important structures, such as the vas deferens, which carries sperm from the testicle.
Once the cyst is removed, the surgeon checks for any bleeding and ensures that the surrounding structures remain intact. The incision is then closed with dissolvable stitches, which do not need to be removed and will naturally disappear over time. The entire procedure usually takes between 15 and 30 minutes.
After surgery
Immediate post-surgery care
Most patients can go home the same day after recovering from the effects of anaesthesia. Following surgery, you can expect to experience some pain, swelling, and bruising, particularly during the first few days after the procedure. This discomfort is usually manageable with pain medication. You may notice a feeling of lumpiness above or behind the testicle; this is a regular part of the healing process and should gradually improve. It is recommended to take showers instead of baths during the recovery period and gently pat the area dry.
Long-term recovery
Recovery over the following weeks involves resting, avoiding strenuous activity, and wearing supportive underwear to help minimise swelling and promote healing. Stitches usually dissolve within 2-3 weeks, and most people feel ready to return to work and resume normal activities after about 10-14 days.
Watch for any signs of complications, such as fever, increased swelling, or unusual discharge from the surgical site. If any of these occur, contact your doctor immediately – early attention can help ensure proper healing and prevent more serious issues.
A standard follow-up appointment with your urologist is typically scheduled within 1-2 weeks to ensure everything is healing correctly and address any concerns you may have.
By following post-operative instructions carefully and allowing time for recovery, most patients experience a smooth return to everyday life, free of the discomfort that the cyst may have caused.
Potential risks and complications
Although the surgery is generally safe and straightforward, it is associated with some potential risks. These include infection, bleeding, and possible injury to nearby structures such as the vas deferens, which could affect fertility. In rare cases, shrinkage of the testicle (testicular atrophy) may occur.
There is also a chance that cysts may recur, either in the original location or on the opposite side. Before proceeding with surgery, it’s essential to have a thorough discussion with your surgeon about these risks and what they mean in your case.
Appointment and Treatment Plan
Initial Consultation
Meet with your urologist to discuss your symptoms, confirm the presence of a cyst through an exam and ultrasound, and discuss treatment options.
Pre-Surgery Preparation
Follow instructions on fasting, stopping certain medications, and arranging a ride home. A brief pre-op check may be needed.
Day of Surgery
The procedure takes 15-30 minutes under general anaesthesia. A small incision is made in the scrotum, the cyst is removed, and dissolvable stitches are used.
Right After Surgery
Expect mild pain, swelling, or bruising. You’ll get home care instructions and can usually go home the same day.
Recovery at Home
Rest for a few days. Avoid heavy activity and wear supportive underwear. Most people return to normal within 1-2 weeks.
Follow-Up Appointment
A check-up within 1-2 weeks ensures proper healing and addresses any concerns or symptoms that may have arisen.
Long-Term Outlook
Most recover fully with no lasting problems. Recurrence is rare, and fertility is usually unaffected.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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Whether you pay in advance, spread the cost, or use your private medical insurance, rest assured you will be receiving exceptional care 365 days a year.
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Many of our treatments have a pay monthly option that allows you to spread the cost of your treatment over 12 months with no credit checks required.
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FAQs
Epididymal cysts are benign, fluid-filled lumps that occur in the epididymis, which is responsible for storing and transporting sperm. These cysts are generally harmless.
Epididymal cysts should be surgically removed when they are large, cause significant pain, or disrupt daily activities. This intervention ensures relief and improves quality of life.
Alternatives to surgical removal of epididymal cysts include conservative management, needle aspiration, and percutaneous sclerotherapy. These options can effectively address the cyst without the need for invasive surgery.
During the recovery period after epididymal cyst surgery, you should expect some pain and swelling, which can be alleviated with pain relief medications. It is advisable to avoid strenuous activities for two weeks; most patients can return home on the same day.
To ensure proper recovery after epididymal cyst surgery, it is essential to keep the wound clean and dry, wear supportive underwear, and monitor for signs of complications such as fever or increased redness. Adhering to these guidelines will promote healing and reduce the risk of infection.