Last updated: March 6, 2024
Epididymal cyst is one of the most common testicular-related issues at my urology office. It was defined as an encysted structure closures the epididymitis which is literally described as a result from prior injuries or inflammations of the epididymis tubule. There’re confirmed evidences that spermatozoa or seminal fluid are the liquid which is lying inside the the cyst. These meaning that epididymal cyst are absolutely a benign lesion.
Natural history of Epididymal cyst
The symptom will usually present as incidentally self-examination painless scrotal swelling during taking a shower. While it always been asymptomatic, so there was 20 – 40% incidentally reported from scrotal ultrasound. The natural history can be something varied from spontaneous resolution, stable or slow growing over times. When mostly they were asymptomatic, so it is highly recommended that, do not digging out any intervention with any sizeable of asymptomatic epididymal cyst. There have been some literatures suggested that epididymal cyst which less than 10 mm can be safely managing as conservative treatment.
A very interesting, randomized trial from India since 2019, they studied various treatment modalities in a different size of the cysts and here are the recommendations.
- < 10 mm
- Conservative treatment with possibility of 95% natural resolution within 3 years.
- 11 – 20 mm
- Conservative treatment with possibility of 66% natural resolution within 3 years.
- Needle aspiration is recommended in symptomatic patients.
- 21 – 50 mm
- 0% of natural resolution within 3 years
- Needle aspiration is recommended in symptomatic patients.
- Surgical excision is the last choice due to risk of infertility
All I can say is, don’t be panic with the cyst. See you in next article!
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Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).
Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.
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