From the Research
Epididymal cysts often don't require treatment unless they cause pain or discomfort, and the most recent and highest quality study recommends conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24-48 months 1.
Treatment Options
- For asymptomatic cysts, watchful waiting is recommended as many resolve on their own, with approximately 50% of epididymal cysts involuting within an average of 17 months 1.
- If the cyst causes pain, over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage discomfort.
- Applying a cold compress to the scrotum for 15-20 minutes several times daily may reduce swelling and pain.
- For persistent discomfort, wearing supportive underwear or a scrotal support can prevent pulling on the spermatic cord.
Surgical Intervention
- For large, painful, or recurrent cysts, surgical removal (spermatocelectomy) may be necessary, performed as an outpatient procedure under local or general anesthesia, with microsurgical epididymal cystectomy being a safe and effective treatment option that does not impact upon sperm count, motility, or morphology 2.
- Microscopic cyst resection is also a beneficial option, with reduced incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain 3.
Postoperative Care
- Postoperative care is generally uncomplicated, with immediate remission of symptoms, although complications such as scrotal edema or hematoma can occur 4.
- Patients should seek medical attention if they notice rapid growth, severe pain, or signs of infection such as redness, warmth, or fever.