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Urology (Expert Forum)
Spermatocelectomy - Is it the first course of action?
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Spermatocelectomy - Is it the first course of action?
by Douglas__0, Aug 23, 1998 12:00AM
After being referred to a urologist for 3 cystic lesions
in the epididymal area of the left testicle. The urologist
immediately diagnosed the condition as spermatoceles
(they appear to be increasing in size,
2 of them are approx 40 mm).
The specialist without hesitation said surgerical removal was
the appropriate treatment. Is there any interim treatment
that could also work prior to the time surgery is indicated
or is surgery typically the only resolution?
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Dear Douglass,
A spermatocele is a cystic structure or out-pouching of the epididymus. The cyst itself is usually firm and non-tender. It is usually filled with sperm and epididymal fluid and considered a benign lesion. It is possible for it to lead to a decrease in fertility however this is uncommon. The most important part of diagnosis is the make sure there is no cancerous lesion. This can be done by a good physical exam or ultrasound.
Whenever I am going to operate on somebody purely for pain or to remove something that is clearly benign, I make sure the patient understands that even if I remove a structure that is abnormal and that more than likely this is the cause of the pain, they must understand that it is possible to have the surgery, remove the structure successfully and the pain still be present.
Your other option in this case are to take anti inflammatory medications (Motrin, Advil, Aleve) and follow conservatively. If the spermatocele continues to grow and the pain increases, surgery is probably your best option. One of my sayings that I would tell my patients in this situation is as follows; I will never tell you, you need to have this operation, you will have to tell me you want this operation.
I don’t know if I cleared up your confusion. They only way to get rid of the spermatocele is by surgery, but your doctor cannot guarantee your pain and problems will subside.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Spermatocele
