Overview

What is a spermatocele?

A spermatocele is a fluid-filled cyst (growth) located above or behind the testicle. Inside each spermatocele is a clear or cloudy fluid that may also contain sperm.

Healthcare providers sometimes call these growths spermatic cysts or epididymal cysts. Spermatoceles develop along the epididymis, which is part of the male reproductive system.

What is the epididymis?

The epididymis is a tube that runs behind and over the top of each testicle. Its main jobs are storing and transporting sperm from the testicle.

Where are spermatocele located?

Spermatoceles occur near (but not directly on) the testicle. A spermatocele can develop on any part of the epididymis.

Often, a spermatocele appears as a small lump right above the testicle. Less commonly, a spermatocele may develop along the lower part of the epididymis (behind the testicle).

How common are spermatoceles?

Spermatoceles are pretty common. They affect close to 1 in 3 adult men. Spermatoceles can affect people at any age, but they commonly appear in midlife (the 40s or 50s).

Can spermatoceles turn into cancer?

No. Spermatoceles are benign cysts, which means they are not cancer. There is no evidence to suggest a spermatocele could turn into cancer. Having a spermatocele does not increase your testicular cancer risk.

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Symptoms and Causes

What causes spermatoceles?

Spermatoceles happen when sperm builds up somewhere in the epididymis. Healthcare providers don’t fully understand the factors that lead to this sperm buildup. Some medical experts point to a blockage in the epididymal duct or inflammation as potential causes.

In many cases, these testicular cysts seem to show up out of nowhere, with no sign of injury, infection or other obvious cause.

What does a spermatocele look like?

Spermatoceles vary in size. They may look like:

Nothing: Some cysts are too tiny to see or feel. These cysts can only be detected with medical imaging, such as ultrasound.
A pea-sized lump: Many spermatoceles look like a small lump that sits right above or behind a testicle. Most have a shape and size similar to a pea.
A large growth: Occasionally, spermatoceles can grow quite large. Some men describe a large spermatocele as looking similar to a third testicle.

What does a spermatocele feel like?

A smaller spermatocele usually causes few or no symptoms. It may not bother you at all. You may not even know you have one. A larger spermatocele may cause mild to moderate symptoms, such as:

Scrotal swelling.
Dull aching or heaviness in scrotum.

Diagnosis and Tests

How are spermatoceles diagnosed?

Because spermatoceles often cause no symptoms, they commonly go undiagnosed. Your provider may detect a spermatocele during a routine physical exam or a medical test for another problem. Some people find a spermatocele when doing a testicular self-exam.

Will I need medical tests to confirm a spermatocele diagnosis?

Your provider may use tests during or after a physical exam. These tests can reveal more about a testicular lump or rule out other testicular disorders:

Transillumination: A provider shines a light onto the lump. Spermatocele (unlike solid growths) look translucent, or partly see-through.
Ultrasound: This noninvasive imaging test uses sound waves to capture fine details of testicular cysts. Ultrasound tests help providers distinguish spermatoceles from other types of scrotal masses (growths), such as testicular cancer. Sonograms are nearly 100% accurate in diagnosing spermatoceles.
Lab tests: If you have testicular pain, your provider may recommend blood tests (such as a complete blood count or CBC test) or urine tests (such as urinalysis). These tests check for possible inflammation or infection.

Management and Treatment

How are spermatoceles treated?

Most spermatoceles remain small in size and cause few or no symptoms. If a spermatocele doesn’t bother you, you may not need treatment.

In more severe cases, a spermatocele can cause long-term pain or other uncomfortable symptoms. Your provider may recommend surgery to remove the cyst.

Who performs spermatocele surgery?

A urologist usually performs surgery to remove a spermatocele cyst. Urologists are doctors with specialized training to treat problems affecting the male reproductive system.

What should I know about spermatocele cyst removal?

Spermatocelectomy is another name for spermatocele cyst removal surgery. It is an outpatient procedure. You go home after surgery instead of staying in the hospital.

During a spermatocelectomy, a provider makes an incision in the scrotum or groin area. Then the provider carefully removes the spermatocele.

Urologists may use local anesthesia to numb the affected area. The numbing keeps you comfortable as you lie awake for the procedure. Or they may use general anesthesia to put you to sleep so you’re safely unaware during surgery.

Spermatocelectomy is generally considered a routine, safe procedure that may improve your symptoms.

Can spermatoceles cause infertility?

No, spermatoceles do not cause male infertility. However, certain spermatocele treatments have the potential to damage reproductive tissues. Surgery poses a small risk, as does a rarely used therapy called aspiration and sclerotherapy. Your provider can explain your treatment options, including how a therapy may affect your reproductive future.

Prevention

Can I prevent spermatoceles?

No. Unfortunately, you can’t prevent spermatoceles from developing. But for many people affected by spermatoceles, the cysts don’t cause any problematic symptoms.

Outlook / Prognosis

What is the prognosis (outlook) for people with spermatocele?

Spermatoceles are a common condition. They usually cause few or no symptoms. Many times, a spermatocele goes undiagnosed because people don’t realize it’s there. The condition doesn’t generally lead to further health problems or pose a serious threat.

Larger spermatoceles may be painful or uncomfortable. In these instances, surgery to remove a spermatocele may provide relief.

Living With

When should I call the doctor?

Rarely, severe groin pain can stem from a serious medical condition, such as cancer or testicular torsion. Call your doctor or seek immediate medical attention if you have worsening testicular pain and swelling that comes on suddenly, with no obvious cause.

A note from Cleveland Clinic

Noticing a lump near your testicle can be unnerving. Reaching out to a provider you trust for an evaluation can offer answers and set your mind at ease. Spermatoceles are common, usually painless testicular cysts (growths) that tend to affect people in midlife. You likely won’t need treatment if a spermatocele doesn’t bother you. Medication or surgery may offer relief for larger cysts that lead to more severe symptoms.

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Spermatocele