Causes
Spermatoceles can originate as diverticulum from the tubules found in the head of the epididymis. Sperm accumulation gradually causes the diverticulum to increase in size, causing a spermatocele. Since there are many tubules connecting the epididymis to the testis, a blockage in one of the tubules may lead to formation of a cyst. In many instances they appear to occur spontaneously without any preceding instances of injury.Scarring of any part of the epididymis due to trauma or inflammation can cause it to become obstructed and in turn form a spermatocele. Diagnosis
Spermatoceles can be discovered as incidental scrotal masses found on physical examination by a physician or by self-inspection of the scrotum and testicles. The various types of diagnosis for spermatocele types include hydrocele, varicocele, hernia, simple epididymal cyst, and neoplasm.The primary care physician may diagnose and manage benign causes of scrotal masses such as hydrocele, varicocele and spermatocele. However, if a "must not miss" diagnoses related to testicular masses such as testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer is suspected, the family physician must refer to a urologist. Finding a painless, cystic mass at the head of the epididymis that is clearly separate from the testicle can indicate a spermatocele. Shining a light through the mass through a process known as transillumination can also help differentiate between a fluid-filled cyst and a tumor, which would not allow as much light to pass. If uncertainty exists, ultrasonography of the scrotum can confirm the presence of a spermatocele.
The incidence of these cysts are possibly linked to boys who are exposed to diethylstilbestrol, an estrogen medication, while in the fetus.Although the evidence and information for incidence of spermatoceles in children is lacking, there are general management guidelines for caregivers who may encounter spermatoceles in their children. Epididymal cysts are typically benign in nature. However, caregivers should take note of any discomfort and symptoms in children, including but not limited to, erythema, scrotal edema or swelling. Epididymal cysts appear in approximately 70% of boys who present as asymptomatic. The diagnosis of epididymal cysts in children can be discovered upon physical examination and eventually confirmed via ultrasound. Treatment
Small cysts as well as asymptomatic larger cysts are better left alone and carefully observed. However, treatment can be considered if the cysts are causing discomfort/pain, enlarging in size, or per patient request. There are a few different treatment options, ranging in levels of invasiveness. Medications
Certain drugs such as oral analgesics or anti-inflammatory medications can be taken by mouth to decrease spermatocele-related symptoms such as pain and/or swelling. At the moment, there is no medication that can inhibit the production of a spermatocele or cure it. Common medications recommended by doctors are acetaminophen (Tylenol) that can treat pain. To treat the inflammation and pain, non-steroidal anti-inflammatory drugs (NSAIDs) are recommended such as ibuprofen (Motrin, Advil), naproxen (Aleve), and others. Antibiotics may also be prescribed in cases where risk of infection and discomfort is indicated.