Hello - thanks for asking your question.
Epididymal cysts are typically painless and harmless. To my knowledge, there is not an association with testicular cancer. It is possible that the trauma from sex may exacerbate the pain.
As for confusion with a varicocele, this is unlikely - normally they can be differentiated from a varicocele on ultrasound.
Sometimes, epididymal cysts can go away on their own. However, if they continue to become uncomfortable, they can be surgically removed or drained.
As for your urologist's advice, it is pretty much the standard treatment for epididymal cysts. Surgery is normally the last resort. If the cyst does not go away on its own, or with Motrin, then surgery may then be considered.
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.
Thanks,
Kevin, M.D.