From the Research
Testicular epididymal cysts typically require no treatment as they are benign, asymptomatic lesions that often resolve spontaneously. The management approach for testicular epididymal cysts should prioritize a conservative approach, with observation and periodic follow-up ultrasounds being the standard management for most cases 1.
Key Considerations
- If the cyst is large (greater than 2 cm), causing pain, or there is diagnostic uncertainty, surgical intervention may be considered 2, 3.
- The surgical options include cyst aspiration, excision of the cyst (cystectomy), or epididymectomy in more extensive cases.
- Prior to any intervention, a thorough evaluation including scrotal ultrasound is essential to differentiate epididymal cysts from other conditions such as spermatoceles, hydroceles, or testicular tumors 4, 5.
- Patients should be reassured about the benign nature of these cysts, which are fluid-filled structures arising from the efferent ductules of the epididymis.
- They typically appear as anechoic, well-circumscribed lesions on ultrasound with no internal blood flow on Doppler examination.
Recommendations
- Regular self-examination of the testicles is recommended to monitor for any changes, with medical attention sought if there is an increase in size, new onset of pain, or other concerning symptoms.
- Asymptomatic epididymal cysts can be safely managed with observation, and patients should be counseled toward conservative management 1.
- The use of scrotoscope as a new alternative technique for epididymal cyst treatment may be a safe and effective option, providing a clear field of vision and making tissues available for pathologic examination 3.