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Cyst on testicle

  I am a 51-yr-old male.  At age 25, a urologist discovered a cyst
  on my left testicle.  He told me not to worry about it and
  recommend that I have no treatment.  Until recently, I have had no
  problems, but now the cyst feels larger.  In particular, my scrotum
  is always tight (it is not large to begin with), and I have a
  feeling of pressure when I have an erection (no pain).  Should I
  be concerned about the cyst (apart from the discomfort)?  What
  treatment(s) are there to reduce the pressure, and how long would
  such treatments last?
Dear Jeff,
Your question is a good one.
By your description and previous evaluation it sounds as if you have a spermatocele (cyst of the epididymis containing sperm) or  a hydrocele (collection of fluid surrounding the testis or involving the spermatic cord). Both are benign conditions in themselves. They may enlarge over time and on the bases of discomfort (physical or emotional) or  cosmetics (how it looks) need treatment. Treatment has been surgical removal and is quite effective. This is usually outpatient surgery but would usually require a few weeks off work. There is a recent article rekindling interest in putting medication into hydroceles to cause scarring and thereby stop the fluid accumulation. This latter procedure is not at this point accepted technique.
In view of the fact that you are experiencing changes in your situation,  I would recommend that you get reevaluated by a urologist to make sure that nothing else is happening. In particular, there is an association between testes tumors and hydroceles and you should be evaluated for this.
Good luck.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital  and its suburban locations (I-800-653-6568).
*Keyword:hydrocele, spermatocele

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