The male reproductive tract is responsible for the production, maturation and delivery of sperm. Sperm are produced in the testicles.
Testicles Paired, egg-shaped glands contained in a pouch (scrotum) below the penis. They produce sperm and the male hormone testosterone. and then are transported via a complex and highly integrated entity through the epididymis and vas deferens. Sperm travel through the vas deferens up through the groin and then in the deep pelvis before they enter the ejaculatory duct and then are released through the penis and out of the urethra during ejaculation. Each component of the reproductive tract is highly specialized. Abnormalities within the male reproductive tract may appear as scrotal masses. Masses may be of little significance or may represent life-threatening illnesses. It is necessary to follow a set course of action to determine the nature of the masses and the most appropriate treatment option. For example, testicular cancer is a source of great concern and uniformly requires prompt intervention. Other masses, such as varicoceles, can cause pain or impair reproductive function. Spermatoceles are benign and generally painless masses that extend near the testicle. Thus, it is important for a patient to seek prompt medical attention when he identifies a scrotal mass or abnormality while performing testicular self examination. The following information will assist you when talking to a urologist about spermatoceles.
What is a spermatoceles ?
Spermatocele, also known as a spermatic cyst, are typically painless, noncancerous (benign) fluid filled cysts that are outpocketing of fluid from the epididymis. They usually sit near the top and/or behind the testicle, but appear separate from the testis. Spermatoceles are typically smooth and they are usually filled with a whitish, cloudy fluid and usually contain sperm. Over time, spermatoceles may remain stable in size or they may grow. If in fact the size becomes bothersome, or results in pain, then there are several treatment options to rectify the problem. Spermatoceles are generally no more than a nuisance rather than a serious medical condition.
What can cause spermatoceles ?
The precise cause of spermatoceles is not known. While spermatoceles may form as a result of trauma or inflammation, these conditions are certainly not required for spermatocele formation. Others suggest that blockage of the efferent ducts and epididymis result in spermatocele formation. Additionally, in utero exposure to diethylstilbestrol (DES), a synthetic form of estrogen, has also been suggested as a possible cause.
How common are spermatoceles ?
The precise incidence of spermatoceles is unknown, but an estimated 30 percent of all men have small spermatoceles with larger sized spermatococeles being much less common.. Incidence increases with age, with peak rates for the diagnosis of spermatoceles occurring in men in their forties and fifties. No racial or ethnic predispositions to spermatocele formation are known.
What are the symptoms of spermatoceles ?
Men with spermatoceles usually have no symptoms. However, when associated symptoms are present, they may include scrotal heaviness and/or dull discomfort but usually not sharp pain.
How are spermatoceles diagnosed ?
Spermatoceles are typically discovered through a man’s self-examination of his testicles or at the time of an evaluation by a physician. Light can be shined through a spermatocele (transillumination), indicating that the mass is not a solid tumor but more likely a benign cyst.Ultrasound examination remains a very reliable means of evaluation and is a relatively quick, noninvasive and inexpensive test. Spermatoceles after surgical treatment ? Patients are generally discharged home with a pressure dressing consisting of an athletic supporter filled with fluffy gauze. Ice packs are applied for two to three days to minimize swelling. Oral pain medications are generally used for one to two days postoperatively. Patients usually may shower at 48 hours after surgery, and a follow-up visit is scheduled for one to three weeks after the procedure. Patients usually wear a scrotal support for 7-14 days after the procedure. Scrotal swelling is usual and will typically last from 2 -21 days.Potential complications of spermatocelectomy are not common but include fever, infection, bleeding (scrotal hematoma), recurrence and persistent pain. Recurrence of a spermatocele occurs in approximately 10-25% of cases. Furthermore, inadvertent epididymal obstruction may result, which can lead to subfertility or infertility. Therefore, intervention should be avoided in men who still desire children.