Question
I went to the urologist, as I identified a lump in my testicle — and as a 30-year-old I was concerned this could have been testicular cancer. We had an ultrasound/inspection of the lump done and I was advised that it was a spermatocele (or spermatic cyst). And that it was ‘normal’ for many men to have this and not to be worried. And that it may vanish over time. This was 1.5 years ago and since then I’ve noticed the lump has grown bigger and actually now has become more tender and at times painful (like when there's pressure caused by my jeans or underwear). I've planned another doctor's appointment but would like to know options in addressing this cyst. Is there treatment options or removal? Should I be concerned about its growth and pain? I would also say I wear underwear briefs (jocks) and am worried that this may have contributed to developing this cyst, due to having more constrained support?
Answer
It’s important to understand the different parts of the male reproductive system that are inside the scrotum (the pouch of skin that hangs below the base of the penis).
The testis (often called testicle) is the egg-shaped organ that usually takes up most of the space in the scrotum, but there is also the epididymis (where sperm mature and are stored), the vas deferens (the tube through which the sperm travel towards the penis), different layers of muscle and connective tissue, and blood vessels. All of this is the same on both the right and left side, but our bodies aren’t perfectly symmetrical, so the sizes and positions of your testicles might be a bit different.
A spermatocele is a cyst located in the epididymis, not the testis. Spermatoceles are usually nothing to worry about because in most cases they are painless and don’t cause problems. Spermatoceles do not cause testicular cancer.
In some men, like you, spermatoceles can increase in size and may become painful. Seeing your doctor about this is the right thing to do. Your GP might suggest anti-inflammatory medication to see if that reduces the size and pain of the spermatocele. If this does not work, a brief surgical procedure can be performed to remove the spermatocele.
We aren’t aware of any evidence suggesting that different types of underwear affect the occurrence of spermatoceles or complications like yours.
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