Epididymal cyst

An epididymal cyst is a benign (non-cancerous) fluid sac that is connected to the epididymis, the structure at the back of the testicle. It may be noticed as a lump in the scrotum and it is important to differentiate this from testicular cancer.

Epididymal cysts usually cause no symptoms. It may cause progressive swelling of the scrotum or may be picked up incidentally on an ultrasound. In some cases they may cause:

• Pain or heaviness in the scrotum
• Discomfort and pressure if very large

An epididymal cyst can be confidently diagnosed with a simple ultrasound of the scrotum. This will also look at the testicles to ensure they are normal in appearance, to exclude a testicular cancer.

The Urologists at Melbourne Urology Centre will take into consideration your personal circumstances in order to determine the most appropriate treatment. This will include an assessment of your overall health.

In most cases, no intervention is required once the diagnosis of an epididymal cyst has been made.

If the cyst becomes very large or is causing symptoms, it is possible to remove it with a small procedure.

Excision of epididymal cyst is a day surgery procedure. It is performed under general anaesthetic and takes around 30 minutes to complete. The surgeon will make a small incision in the scrotum to excise the cyst and the wound will be closed using dissolving sutures.

Most patients will make a quick recovery after surgery but it is important to avoid any strenuous activity for at least one to two weeks to minimize the chance of bleeding. Most patients will notice some bruising and swelling after the procedure. You should use simple painkillers such as paracetamol or anti-inflammatories as well as supportive firm-fitting underwear. Some patients may use an ice pack to help reduce pain and swelling in the area. The stitches usually dissolve after a few weeks and infections are uncommon.

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa