What Are Spermatoceles?
A spermatocele is an abnormal growth or sac that develops above or behind the testicles. Usually, it develops in the long coiled tube near the upper part of the testicles that collect the sperm, known as the epididymis. Therefore, spermatoceles are also known as epididymal or testicular cysts, usually benign or non-cancerous. Spermatoceles are usually filled with a milky or cloudy fluid that might contain sperm. The doctors are still unclear about the exact cause of spermatoceles. However, they suspect they occur due to a blockage in the tube that transports the sperm. Studies have reported that these spermatoceles do not affect fertility or require treatments. The doctor will recommend the treatment only when the spermatocele grows large enough to bother or hurt the person suffering from it. The main function of the male reproductive system is to regulate the growth, maturation, and delivery of sperm. Spermatocele or other masses form when it fails to perform its activities. Sometimes, it might indicate something serious, and the doctor treats the condition according to the nature of the disease.
What Are Testicles?
The testicles are an important part of the male reproductive system that produces and stores sperm. They are paired and oval-shaped structures inside the body in intrauterine life. However, before the baby is born, these testicles descend into a pouch of skin known as the scrotum. The scrotum regulates the temperature and provides an optimal environment for the production of sperm. In addition, a long coiled tube known as the epididymis is present near the testis. It contains the nerves and blood vessels that nourish the testicles. Typically, the epididymis and vas deferens regulate the synthesis and storage of sperm. However, the problem arises when these structures become blocked due to sperm accumulation and spermatoceles.
What Are the Causes of Spermatocele?
The etiological factors behind the formation of spermatoceles are unknown. However, research has reported that they usually occur due to the blockage in one or more of the tubes present in the epididymis that store and transport the sperm. The doctors are unaware of the factors that lead to the accumulation of these sperms. Some researchers believe that inflammation of the epididymis blocks sperm flow. In rare cases, the spermatoceles or testicular cysts appear due to unknown causes with no signs of injury, infection, or other causes. There are no specific factors that increase the risk of a spermatocele. However, it was discovered that men whose mothers were given Diethylstilbestrol (DES) during pregnancy or other complications had a higher risk of spermatoceles.
What Are the Signs and Symptoms of Spermatocele?
The patient might not experience any signs and symptoms due to spermatocele because it usually remains stable in size. However, the following symptoms usually arise when the spermatocele becomes big;
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Pain and discomfort in the affected testicle.
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Heaviness in the affected testis.
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A feeling of fullness above and behind the testicles.
How Can a Patient Examine His Testicles and Look for Spermatoceles?
A patient can self-examine his testicles and other abnormalities. The best time to examine the testicles is during or after a warm bath because water relaxes the scrotum making it easier to detect testicular abnormalities. The following steps help in the self-examination of testicles:
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Stand in front of the mirror and look for any sign of swelling on the skin of the testicles.
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Place the index finger and middle finger beneath the testicles and the thumb above the testis to examine and palpate it.
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Testicles are smooth and oval-shaped structures, so gently roll them between the thumb and the fingers to examine their shape and size. The size of the two testicles varies, and usually, one testicle is larger than the other.
How Is a Spermatocele Diagnosed?
A physical examination can easily diagnose spermatocele, but the patient might feel a little pain and discomfort while the doctor palpates the testis. The diagnostic methods are listed below:
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Transillumination: The doctor examines the testis and might shine light through the scrotum. In the case of spermatocele, the light will indicate the fluid-filled mass in the scrotum.
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Ultrasound: Ultrasound is a simple imaging procedure to diagnose scrotal swelling or spermatocele when transillumination fails. The doctor moves the transducer over the patient’s abdomen to send sound waves into the body. These images help distinguish between the spermatocele and scrotal swelling.
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Laboratory Tests: If spermatocele is accompanied by pain or inflammation, the doctor might order a blood test or a urine test to detect other etiological factors.
How Is a Spermatocele Managed?
Normally, the spermatocele does not subside on its own, but most do not require any treatment. This is because the patient rarely experiences pain or other complications due to spermatoceles. However, the doctor might recommend over-the-counter drugs like Acetaminophen or Ibuprofen if it is painful. The other treatment options are described below:
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Surgery: A surgical procedure known as spermatocelectomy is done under local or general anesthesia. The primary aim of this procedure is to separate the spermatocele from the epididymis. The doctor makes an incision near the scrotum and segregates the cystic swelling from the long coiled tube known as the epididymis. After the surgery, the patient might need to wear athletic support to apply pressure and support the incision site. The doctor might ask the patient to apply ice packs for two to three days after the surgery and take painkillers to overcome the pain. The possible complications of spermatocelectomy that might affect male fertility are damage to the epididymis and vas deferens. There are high chances of recurrence of spermatocele after the surgery.
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Aspiration and Sclerotherapy: The doctor might rarely recommend aspiration with sclerotherapy. A needle is inserted into the spermatocele during the procedure, and the cystic fluid is removed or aspirated. However, if the spermatocele recurs even after aspiration, the doctor might aspirate the fluid and inject the chemical into the sac. This procedure is mainly known as sclerotherapy. The irritating chemical causes scarring of the spermatocele sac and takes up the space occupied by the cystic fluid. Hence, the risk of recurrence of a spermatocele is lowered. The most common complication of sclerotherapy is damage to the epididymis.
Can Surgery Protect Fertility?
Surgery can potentially damage the epididymis and vas deferens, whereas sclerotherapy might damage the epididymis. Therefore, the fertility of the person might get affected due to spermatocele. Sometimes, the doctor might recommend delaying the procedure until the person becomes a father. However, suppose the pain is unbearable, and the patient feels his daily activities are hampered due to the spermatocele. In that case, he must not delay the surgery and consult his doctor immediately.
Conclusion:
Spermaotcele is a common condition that typically affects males. It usually occurs due to the blockage in the tubes that store or carry the sperm outside the male reproductive tract. The biggest problem associated with this condition is that it damages the structures responsible for sperm formation. As a result, it can affect male fertility. However, the patient should not worry because he will rarely experience any signs or symptoms due to a spermatocele. Sometimes, the patient can get cured by over-the-counter drugs or surgery. So, the patient must not become anxious and consult the doctor to know more about the management of spermatoceles.
