Spermatocele Removal Options

I am 48 and was researching having a vasectomy as I have no intention of fathering more children. I found lots of negative stories out there so have put it off. In the mean time I learned from a personal exam and doctor's exam with ultrasound that I have a Spermatocele on the right testicle about the size of say a dime to nickle diameter sphere. It is slightly painful to the touch but not not otherwise. I read many men get these from having a vasectomy. A couple questions are... 1) if I get the vasectomy should I have it removed at that time or could it just get worse, it really bothers me psychologically knowing it is there but I wouldnt want something worse. 2) If I leave it alone, what will likely happen to it, increase in size, become cancerous, could it go away, etc? 3) Given I need the vasectomy anyway are there doctors that would refuse to excise it in the process and/or would my HMO try and disallow it? 4) Do they often just come back and be even worse than if left alone? It is just one of those areas of my health than I cant stop obsessing about. Please provide as much information as possible. I am not new nor shy to surgeries and have never had any problems, I am in otherwise good health. I have had two knee and three back surgeries of necessity in my life with benefit each time. Thanks very much.

[Kevin Pho, MD]

To answer your questions:
1) Typically spermatoceles are observed unless symptoms are present - then surgery for removal can be considered.

2) Spermatoceles rarely cause problems and I am not aware of a connection between this and cancer.  It is possible that it may increase in size, but in most cases they are asymptomatic.

3) I cannot comment on this without knowing your physicians or your HMO process.

4) Cannot say for sure.  The majority of spermatoceles do not cause problems and are merely observed.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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