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Treatments and drugs
By Mayo Clinic staffAlthough your spermatocele probably won't go away on its own, most spermatoceles don't need treatment. They generally don't cause pain or complications. If yours is painful, your doctor may recommend that you take over-the-counter pain medications, such as acetaminophen (Tylenol, others) or ibuprofen (Motrin, Advil, others).
Surgical treatment
A procedure called a spermatocelectomy generally is performed on an outpatient basis, using local or general anesthetic. The surgeon makes an incision in the scrotum and separates the spermatocele from the epididymis.
After surgery, you may need to wear a gauze-filled athletic supporter to apply pressure to and protect the site of the incision. Your doctor may also tell you to:
- Apply ice packs for two or three days to keep swelling down
- Take oral pain medications for a day or two
- Return for a follow-up exam about two weeks after surgery
Possible complications from surgical removal that might affect fertility include damage to the epididymis or to the tube that transports sperm (vas deferens). It's also possible that a spermatocele may come back, even after surgery.
Sclerotherapy
Another treatment that's not used as often is called sclerotherapy. This treatment begins by removing the fluid from the spermatocele and then injecting an irritating chemical into the sac. The irritating agent causes the spermatocele sac to scar, which takes up the space the fluid occupied and may lower the risk of the spermatocele coming back.
Damage to the epididymis is a possible complication of sclerotherapy. It's also possible that your spermatocele may come back. Sclerotherapy usually is used only for men who are beyond their reproductive years.
- Spermatoceles. American Urological Association Foundation. http://www.urologyhealth.org/urology/index.cfm?article=117. Accessed Dec. 7, 2011.
- Brenner JS, et al. Causes of painless scrotal swelling in children and adolescents. http://www.uptodate.com/home/index.html. Accessed Dec. 7, 2011.
- Tiemestra JD, et al. Evaluation of scrotal masses. American Family Physician. 2008;78:1165.
- Wampler SM. Common scrotal and testicular problems. Primary Care Clinics Office Practice. 2010;37:613.
- Montgomery JS. The diagnosis and management of scrotal masses. Medical Clinics of North America. 2011;95:235.
- Painless scrotal mass. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/symptoms_of_genitourinary_disorders/painless_scrotal_mass.html. Accessed Dec. 7, 2011.
- Jahnson S, et al. A randomized trial comparing 2 doses of polidocanol sclerotherapy for hydrocele or spermatocele. The Journal of Urology. 2011;186:1319.
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