What are the causes of a spermatocele (epididymal cyst)?

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Last updated: April 22, 2025View editorial policy

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From the Guidelines

Spermatoceles are primarily caused by blockage of the tubules that transport sperm, which may occur due to inflammation or infection of the epididymis, trauma to the testicles, or prior vasectomy procedures, as well as abnormal dilation of the tubules in the epididymis or congenital abnormalities in the reproductive tract. The exact cause of spermatocele is often unknown, but it is believed to result from obstruction, which can be suggested by induration or dilation of the epididymides, as noted in a 2021 guideline on the diagnosis and treatment of infertility in men 1. Some key factors that may contribute to the development of spermatoceles include:

  • Inflammation or infection of the epididymis
  • Trauma to the testicles
  • Prior vasectomy procedures
  • Abnormal dilation of the tubules in the epididymis
  • Congenital abnormalities in the reproductive tract It is essential to identify the underlying cause of a spermatocele to differentiate it from more serious conditions like testicular cancer or epididymitis that may require immediate medical attention. Epididymal cysts or spermatoceles may also lead to obstruction, as mentioned in the 2021 guideline 1. Understanding the potential causes of spermatoceles helps in providing appropriate treatment and care, especially since they are typically benign and don't affect fertility or sexual function, unless they cause discomfort.

From the Research

Causes of Spermatocele

  • The exact causes of spermatocele are not explicitly stated in the provided studies, but they can be related to various factors such as epididymal injury or obstruction 2.
  • Spermatoceles are benign cystic dilations of the epididymis, and their formation may be associated with increased intraluminal pressure in the efferent ducts, epididymis, and vas deferens after vasectomy 3.
  • Some studies suggest that spermatoceles may be asymptomatic and do not need correction unless they lead to impairment of the patient 4.
  • The size of the spermatocele may be a factor in seeking treatment, with men seeking intervention when the lesion approximates the size of a testicle 5.

Related Factors

  • Epididymal injury or obstruction can occur during hydrocelectomy and spermatocelectomy, which may lead to infertility 2.
  • Vasectomy can cause changes in the epididymis and testis, including thickened epididymides, epididymal tubular ectasia, and sperm granulomas 6, 3.
  • Scrotal pain or discomfort after vasectomy may be related to factors other than obstruction, such as ultrasonographic features of the testis and epididymis 6.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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