{"id":3474,"date":"2021-07-30T08:00:00","date_gmt":"2021-07-30T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=3474"},"modified":"2026-08-30T03:34:53","modified_gmt":"2026-08-29T20:34:53","slug":"%d8%a7%d9%84%d9%83%d9%8a%d8%b3-%d8%a7%d9%84%d8%a8%d8%b1%d8%a8%d8%ae%d9%8a-%d9%83%d9%8a%d9%81-%d9%86%d8%aa%d8%b9%d8%a7%d9%85%d9%84","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ar\/2021\/07\/30\/epididymal-cyst-how-we-deal\/","title":{"rendered":"\u0643\u064a\u0633 \u0627\u0644\u0628\u0631\u0628\u062e: \u0645\u0627 \u0647\u0648\u060c \u0648\u0645\u062a\u0649 \u064a\u062d\u062a\u0627\u062c \u0625\u0644\u0649 \u0639\u0644\u0627\u062c"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, 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Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size has-custom-font-size wp-element-button\" href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" style=\"color:#1b4965\" target=\"_blank\" rel=\"noreferrer noopener\">Book a 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0 .242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">The epididymal cyst is one of the commonest testicular problems I see. It is a fluid-filled sac arising from the epididymis \u2014 the coiled tube that sits behind the testicle \u2014 and it forms after previous injury or inflammation of the epididymal tubule. The single most important thing to know is that it is a <strong>benign lesion<\/strong>. It is not cancer, and in most cases it needs nothing done to it at all.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That reassurance comes with one condition, and it is important enough to state before anything else.<\/p>\n\n\n<script type=\"application\/ld+json\">\r\n{\r\n  \"@context\": \"https:\/\/schema.org\",\r\n  \"@type\": \"FAQPage\",\r\n  \"mainEntity\": [\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What is an epididymal cyst?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"An epididymal cyst is a benign fluid-filled sac that forms near the epididymis, typically as a result of prior injury or inflammation of the epididymal tubule. The fluid inside contains spermatozoa or seminal fluid. It is completely benign and not cancerous.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What are the symptoms of an epididymal cyst?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Most epididymal cysts are asymptomatic and are discovered incidentally during self-examination in the shower as a painless scrotal swelling. They are found incidentally in 20\u201340% of scrotal ultrasound studies. Some patients may experience mild scrotal discomfort.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Is an epididymal cyst dangerous or cancerous?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"No. An epididymal cyst is a completely benign lesion and does not become cancerous. It does not pose a serious health risk, though it can cause discomfort if it grows large.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Does an epididymal cyst go away on its own?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"It depends on the size. Cysts smaller than 10 mm have a 95% chance of resolving naturally within 3 years. Cysts between 11\u201320 mm have a 66% chance of natural resolution. Cysts larger than 20 mm have 0% chance of resolving on their own and may require intervention.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"When does an epididymal cyst need treatment?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Asymptomatic epididymal cysts of any size are best managed conservatively without intervention. Treatment is only considered when the cyst causes symptoms. Needle aspiration is recommended for symptomatic cysts between 11\u201350 mm. Surgical excision is the last resort for large symptomatic cysts due to the risk of affecting fertility.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Can surgery for an epididymal cyst affect fertility?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Yes. Surgical excision of an epididymal cyst carries a risk of damage to the epididymis, which can potentially affect fertility. For this reason, surgery is only considered as a last resort for large symptomatic cysts that have not responded to other treatments.\"\r\n      }\r\n    }\r\n  ]\r\n}\r\n<\/script>\n\n\n\n<h4 class=\"wp-block-heading\">First: make sure it is actually a cyst<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Everything on this page applies to a lump that <em>has been confirmed<\/em> as an epididymal cyst. It does not apply to a lump you have found yourself and decided is probably one. <strong>Please do not use this article to reassure yourself about a lump nobody has examined.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The reason is testicular cancer. It is uncommon overall, but it is the most common cancer in young men \u2014 roughly the teens to the forties, the same age group most likely to find a lump in the shower and look it up online. It is also one of the most curable cancers there is when it is caught early, and that is exactly why the delay caused by self-reassurance is the thing worth preventing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The distinction a doctor makes is largely about <em>where<\/em> the lump is. An epididymal cyst sits behind or above the testicle and can usually be felt as separate from it \u2014 you can get your fingers between the lump and the testicle itself. A lump that is <strong>within the body of the testicle<\/strong>, firm, and part of the testicle rather than attached to it, is the one that needs urgent assessment. Please do not try to make that call yourself in the bathroom. An ultrasound settles it quickly and painlessly, and a normal result is worth the visit for the peace of mind alone.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>See a doctor without delay<\/strong> for any new lump or swelling in the testicle itself, a testicle that has become firm or changed in size or shape, a persistent dull ache or heaviness in the scrotum, or any lump you are not certain about.<\/li>\n\n\n\n<li><strong>Go to an emergency department the same day \u2014 in Thailand call 1669<\/strong> \u2014 for sudden severe testicular pain, particularly if it comes with nausea or vomiting or wakes you from sleep. Twisting of the testicle is a surgical emergency and the testicle can be lost within hours. Do not wait to see whether it settles. Also go the same day for a hot, red, swollen scrotum with fever.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"3482\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/2021\/07\/30\/epididymal-cyst-how-we-deal\/sad-young-man-in-the-morning-under-blanket-in-bed-lies\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;5.6&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;Image of a sad young man in the morning under blanket in bed lies.&quot;,&quot;created_timestamp&quot;:&quot;1551620305&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;57&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.008&quot;,&quot;title&quot;:&quot;Sad young man in the morning under blanket in bed lies.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"The symptom will usually present as incidentally self-examination painless scrotal swelling during taking a shower.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;The symptom will usually present as incidentally self-examination painless scrotal swelling during taking a shower.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?resize=800%2C533&#038;ssl=1\" alt=\"A man performing a scrotal self-examination and finding a painless lump\" class=\"wp-image-3482\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/Incidental-finding.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Most epididymal cysts are found by chance \u2014 a painless lump noticed in the shower. Any new lump should be examined before it is assumed to be one.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">The natural history of an <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31039113\/\">epididymal cyst<\/a><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Most cause no symptoms at all, and 20\u201340% are picked up incidentally on a scrotal ultrasound done for another reason. From there a cyst may disappear on its own, stay exactly as it is, or grow slowly over years. Because of this, the strong recommendation is <strong>not to intervene on an asymptomatic epididymal cyst<\/strong> \u2014 treatment carries risk, and simply watching does not.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What the size tells you<\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Under 10 mm<\/strong> \u2014 conservative management. Around 95% resolve naturally within 3 years.<\/li>\n\n\n\n<li><strong>11\u201320 mm<\/strong> \u2014 conservative management. Around 66% resolve naturally within 3 years. Needle aspiration is an option if the cyst is symptomatic.<\/li>\n\n\n\n<li><strong>21\u201350 mm<\/strong> \u2014 essentially 0% resolve naturally within 3 years. Needle aspiration is an option if symptomatic. Surgical excision is a last resort, because of the risk to fertility.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Read those percentages as a reason for patience rather than as a countdown. A small cyst that is not bothering you is very likely to sort itself out, and a larger one that is not bothering you still does not need anything done \u2014 size on its own is not a reason to treat. What changes the plan is symptoms, not millimetres.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"3481\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/2021\/07\/30\/epididymal-cyst-how-we-deal\/surgeon-cutting-cotton-from-scissor-in-operation-room\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Surgeon cutting cotton from scissor in operation room at hospital&quot;,&quot;created_timestamp&quot;:&quot;1470109064&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Surgeon cutting cotton from scissor in operation room&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Surgical excision will be considered in &gt; 2 cm symptomatic epididymal cyst.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Surgical excision will be considered in &gt; 2 cm symptomatic epididymal cyst.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Ultrasound measurement of a large epididymal cyst over 2 cm in diameter\" class=\"wp-image-3481\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/07\/If-more-than-2-cm.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Surgery is considered only for symptomatic cysts larger than 2 cm.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">A word on aspiration, since it sounds like the obvious middle path. Draining a cyst with a needle relieves it, but the sac that produced the fluid is still there, so it commonly fills again \u2014 sometimes within months. That is not a reason to avoid it, particularly if you want relief without an operation, but it is worth going in expecting a possible repeat rather than a permanent fix.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Why is surgery held back so firmly? Because the epididymis carries sperm, and excising a cyst from it risks damaging that pathway. For a benign lump that may well have shrunk on its own, that is a poor trade \u2014 which is why aspiration and observation come first. This matters most for men who have not yet had the children they want, and it is a conversation worth having explicitly before any operation is booked rather than afterwards.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The short version: do not panic about the cyst. Have it assessed properly so the diagnosis is certain, then in most cases simply leave it alone.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Q1: I have found a lump. How do I know it is a cyst and not something serious?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">You do not, and that is the honest answer. An epididymal cyst sits behind or above the testicle and can usually be felt as separate from it, whereas a lump within the body of the testicle, firm and part of the testicle itself, is the one that needs urgent assessment \u2014 testicular cancer is uncommon overall but is the commonest cancer in young men, and it is highly curable when found early. A scrotal ultrasound settles the question quickly and painlessly. Do not use online reading to reassure yourself about a lump that nobody has examined; have any new lump, swelling, change in size or shape, or persistent ache checked without delay.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q2: Is an epididymal cyst dangerous?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. An epididymal cyst is a benign (non-cancerous) lesion. It contains spermatozoa or seminal fluid and forms as a result of prior injury or inflammation of the epididymis tubule. The vast majority of epididymal cysts are harmless and do not require treatment unless they cause significant discomfort or grow to a large size. This applies to a cyst that has been confirmed as such on examination and ultrasound.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q3: What scrotal symptoms need emergency care?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Sudden severe testicular pain, especially with nausea or vomiting or pain that wakes you from sleep, needs an emergency department the same day \u2014 in Thailand you can call 1669. Twisting of the testicle cuts off its blood supply and the testicle can be lost within hours, so this is not something to watch and see. A hot, red, swollen scrotum with fever also needs same-day assessment. An epididymal cyst does not cause any of these.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q4: Do epididymal cysts go away on their own?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Many epididymal cysts resolve spontaneously, particularly smaller ones. Cysts less than 10 mm have a 95% chance of natural resolution within 3 years. Cysts between 11-20 mm have a 66% chance of resolution. However, larger cysts of 21-50 mm have essentially 0% chance of natural resolution and may require intervention if symptomatic \u2014 though a large cyst causing no trouble still needs nothing done.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q5: When does an epididymal cyst need treatment?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment is generally recommended only when the cyst causes significant symptoms such as persistent scrotal pain or discomfort. Asymptomatic cysts are managed conservatively regardless of size. Needle aspiration is an option for symptomatic cysts, while surgical excision is reserved as a last resort due to the risk of fertility impairment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q6: Does draining the cyst fix it permanently?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Usually not permanently. Aspiration removes the fluid and relieves the symptoms, but the sac that produced the fluid remains, so the cyst commonly refills, sometimes within months. It is still a reasonable option for a symptomatic cyst in someone who wants relief without an operation, provided you go in understanding that a repeat may be needed rather than expecting a one-off cure.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q7: Can an epididymal cyst affect fertility?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">An untreated asymptomatic epididymal cyst does not typically affect fertility. However, surgical excision carries a risk of damaging the epididymis and impairing sperm transport. This is why surgery is considered only as a last resort for large, symptomatic cysts, and why men who have not yet completed their families should raise this explicitly before an operation is planned rather than afterwards.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q8: How is an epididymal cyst diagnosed?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Epididymal cysts are most commonly discovered incidentally during scrotal self-examination or detected on scrotal ultrasound. Ultrasound is the gold standard imaging tool for diagnosing and characterizing epididymal cysts, confirming their benign nature and measuring their size. Any new scrotal lump should be assessed by a doctor so the diagnosis is certain before it is assumed to be benign.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Q9: Can I discuss a scrotal lump by video consultation?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Partly. A video consultation is useful for reviewing an ultrasound report you already have and for planning, and Bangkok Hospital Headquarters offers a Telemedicine service arranged in advance by email to the Urology department at bhquro@bdms.co.th. But a lump that has not yet been examined and scanned cannot be assessed by video, and should not be \u2014 this is one of the few things where the physical examination and the ultrasound genuinely cannot be skipped. Samitivej Sriracha is in-person only, booked through the Urology department line 088-022-1445.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have discovered a scrotal lump or been told you have an epididymal cyst and would like a specialist evaluation, Dr. Soarawee Weerasopone offers consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a>. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>. Questions about the cost of a consultation, scan or procedure should go to the hospital directly \u2014 for Bangkok Hospital, by email to <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Reference<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Natural history and management of epididymal cysts. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31039113\/\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed 31039113<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice, and it must not be used to self-diagnose a scrotal lump that has not been examined. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment. In an emergency, attend the nearest emergency department \u2014 in Thailand the emergency number is 1669.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/\",\n      \"name\": \"Epididymal Cyst: What It Is, and When It Needs Treating\",\n      \"description\": \"An epididymal cyst is a benign scrotal lump, but only once it has been confirmed as one. How a cyst is distinguished from a testicular lump, which scrotal symptoms are emergencies, what the 10 mm, 20 mm and 50 mm thresholds predict about natural resolution, why asymptomatic cysts are left alone whatever their size, and why surgical excision is a last resort because of the risk to fertility.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-07-30\",\n      \"dateModified\": \"2026-08-30\",\n      \"lastReviewed\": \"2026-08-30\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"medicalAudience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"disambiguatingDescription\": \"This material describes management of a lump already confirmed as an epididymal cyst on examination and scrotal ultrasound. It is not a basis for self-diagnosis of an unexamined scrotal lump. Testicular cancer is the commonest malignancy in young men and is highly curable when detected early, so any new scrotal lump, testicular swelling, change in size or consistency, or persistent scrotal ache requires prompt clinical assessment.\",\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/#epididymal-cyst\" }\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/#epididymal-cyst\",\n      \"name\": \"Epididymal cyst\",\n      \"alternateName\": \"Spermatocele\",\n      \"description\": \"A benign fluid-filled sac arising from the epididymis, the coiled tube behind the testicle, forming after previous injury or inflammation of the epididymal tubule. It is not cancer. Most cause no symptoms and 20-40% are found incidentally on scrotal ultrasound performed for another reason. Natural resolution within three years is around 95% for cysts under 10 mm and around 66% for 11-20 mm, but essentially nil for cysts of 21-50 mm. Size alone does not indicate treatment; symptoms do.\",\n      \"signOrSymptom\": {\n        \"@type\": \"MedicalSignOrSymptom\",\n        \"name\": \"Painless lump above or behind the testicle, palpably separate from the testis\"\n      },\n      \"differentialDiagnosis\": [\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": {\"@type\": \"MedicalCondition\", \"name\": \"Testicular tumour\"},\n          \"distinguishingSign\": {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"A firm lump arising within the body of the testis rather than separate from it, or a testis that has changed in size, shape or consistency, with or without a dull ache or heaviness. Testicular cancer is uncommon overall but is the commonest malignancy in men from the teens to the forties and is highly curable when found early, so prompt examination and scrotal ultrasound are required rather than self-reassurance\"}\n        },\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": {\"@type\": \"MedicalCondition\", \"name\": \"Testicular torsion\"},\n          \"distinguishingSign\": {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Sudden severe testicular pain, often with nausea or vomiting or waking the patient from sleep. A surgical emergency: the testis can be lost within hours, so same-day emergency assessment is required and the emergency number in Thailand is 1669\"}\n        },\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": {\"@type\": \"MedicalCondition\", \"name\": \"Epididymo-orchitis\"},\n          \"distinguishingSign\": {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Hot, red, swollen and tender scrotum, often with fever; needs same-day assessment\"}\n        }\n      ],\n      \"typicalTest\": {\n        \"@type\": \"MedicalTest\",\n        \"name\": \"Scrotal ultrasound\",\n        \"description\": \"The reference investigation. It confirms the benign cystic nature of the lump, distinguishes it from an intratesticular mass, and measures its size, which then guides management. It is quick and painless, and a normal result has value in itself.\"\n      },\n      \"possibleTreatment\": [\n        {\n          \"@type\": \"MedicalTherapy\",\n          \"name\": \"Observation\",\n          \"description\": \"The recommended approach for an asymptomatic cyst of any size. Intervention carries risk and observation does not, and small cysts frequently resolve without treatment.\"\n        },\n        {\n          \"@type\": \"MedicalProcedure\",\n          \"name\": \"Needle aspiration\",\n          \"description\": \"An option for a symptomatic cyst, considered before surgery. It relieves symptoms but does not remove the sac, so recurrence is common and patients should be counselled to expect a possible repeat rather than a permanent cure.\"\n        },\n        {\n          \"@type\": \"MedicalProcedure\",\n          \"name\": \"Surgical excision\",\n          \"description\": \"A last resort, reserved for large symptomatic cysts. Because the epididymis carries sperm, excision risks damaging that pathway and impairing fertility, which is a poor trade for a benign lump that may resolve on its own. Fertility intentions should be discussed explicitly before the operation is planned.\"\n        }\n      ]\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/07\/30\/epididymal-cyst-how-we-deal\/#webpage\" },\n      \"mainEntity\": [\n        {\"@type\": \"Question\", \"name\": \"I have found a lump. How do I know it is a cyst and not something serious?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"You do not, and that is the honest answer. An epididymal cyst sits behind or above the testicle and can usually be felt as separate from it, whereas a lump within the body of the testicle, firm and part of the testicle itself, needs urgent assessment. Testicular cancer is uncommon overall but is the commonest cancer in young men, and it is highly curable when found early. A scrotal ultrasound settles the question quickly and painlessly. Do not use online reading to reassure yourself about a lump nobody has examined: have any new lump, swelling, change in size or shape, or persistent ache checked without delay.\"}},\n        {\"@type\": \"Question\", \"name\": \"Is an epididymal cyst dangerous?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"No. An epididymal cyst is a benign, non-cancerous lesion containing spermatozoa or seminal fluid, formed after prior injury or inflammation of the epididymal tubule. The vast majority are harmless and need no treatment unless they cause significant discomfort. 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Cysts of 21-50 mm have essentially no chance of natural resolution and may need intervention if symptomatic, though a large cyst causing no trouble still needs nothing done.\"}},\n        {\"@type\": \"Question\", \"name\": \"When does an epididymal cyst need treatment?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Only when it causes significant symptoms such as persistent scrotal pain. Asymptomatic cysts are managed conservatively regardless of size. Needle aspiration is an option for symptomatic cysts; surgical excision is a last resort because of the risk of impairing fertility.\"}},\n        {\"@type\": \"Question\", \"name\": \"Does draining the cyst fix it permanently?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Usually not permanently. Aspiration removes the fluid and relieves symptoms, but the sac that produced the fluid remains, so the cyst commonly refills, sometimes within months. It is still a reasonable option for a symptomatic cyst in someone who wants relief without an operation, provided the possibility of a repeat is understood beforehand.\"}},\n        {\"@type\": \"Question\", \"name\": \"Can an epididymal cyst affect fertility?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"An untreated asymptomatic cyst does not typically affect fertility. Surgical excision, however, risks damaging the epididymis and impairing sperm transport, which is why surgery is reserved for large symptomatic cysts as a last resort, and why men who have not yet completed their families should raise this explicitly before an operation is planned.\"}},\n        {\"@type\": \"Question\", \"name\": \"How is an epididymal cyst diagnosed?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Most are found incidentally on scrotal self-examination or on scrotal ultrasound. Ultrasound is the gold standard for diagnosis, confirming the benign nature of the cyst and measuring its size, which then guides management. Any new scrotal lump should be assessed by a doctor so the diagnosis is certain before it is assumed to be benign.\"}},\n        {\"@type\": \"Question\", \"name\": \"Can I discuss a scrotal lump by video consultation?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Partly. A video consultation is useful for reviewing an ultrasound report already obtained and for planning, and Bangkok Hospital Headquarters offers a Telemedicine service arranged in advance by email to the Urology department at bhquro@bdms.co.th. But a lump that has not yet been examined and scanned cannot be assessed by video and should not be: the physical examination and the ultrasound cannot be skipped. Samitivej Sriracha is in-person only, booked through the Urology department line 088-022-1445.\"}}\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>\u0625\u0646 \u0638\u0647\u0648\u0631 \u0643\u062a\u0644\u0629 \u063a\u064a\u0631 \u0645\u0624\u0644\u0645\u0629 \u0641\u0648\u0642 \u0627\u0644\u062e\u0635\u064a\u0629 \u0623\u062b\u0646\u0627\u0621 \u0627\u0644\u0627\u0633\u062a\u062d\u0645\u0627\u0645 \u064a\u064f\u0639\u062f \u0623\u0645\u0631\u0627\u064b \u0645\u0642\u0644\u0642\u0627\u064b - \u0644\u0643\u0646 \u0643\u064a\u0633 \u0627\u0644\u0628\u0631\u0628\u062e \u062d\u0645\u064a\u062f\u060c \u0648\u0645\u0639\u0638\u0645 \u0627\u0644\u0623\u0643\u064a\u0627\u0633 \u0627\u0644\u0635\u063a\u064a\u0631\u0629 \u062a\u062e\u062a\u0641\u064a \u0645\u0646 \u062a\u0644\u0642\u0627\u0621 \u0646\u0641\u0633\u0647\u0627. \u064a\u0648\u0636\u062d \u0627\u0644\u062f\u0643\u062a\u0648\u0631 \u0633\u0648\u0631\u0627\u0648\u064a\u0647 \u0648\u064a\u0631\u0627\u0633\u0648\u0628\u0648\u0646\u060c \u0623\u062e\u0635\u0627\u0626\u064a \u0627\u0644\u0645\u0633\u0627\u0644\u0643 \u0627\u0644\u0628\u0648\u0644\u064a\u0629 \u0641\u064a \u0645\u0633\u062a\u0634\u0641\u0649 \u0628\u0627\u0646\u0643\u0648\u0643\u060c \u0645\u0627 \u064a\u0639\u0646\u064a\u0647 \u062d\u062c\u0645 \u0627\u0644\u0643\u064a\u0633 \u0628\u0627\u0644\u0646\u0633\u0628\u0629 \u0644\u0645\u0627 \u0633\u064a\u062d\u062f\u062b \u0628\u0639\u062f \u0630\u0644\u0643.<\/p>","protected":false},"author":185281453,"featured_media":10041,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Epididymal cyst: a benign scrotal lump. 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