Spermatocele After Vasectomy

Spermatocele is a closed sac filled with sperm that develops on the top of the testicles on epididymis (a tube that carries sperm).

The sac may contain white color sperm inside it.

Spermatocele varies in size; it can be a few millimeters to several centimeters in size.

You might be having one and you won’t ever notice its presence as spermatoceles do not normally produce pain unless they become very big in size.

Spermatocele After Vasectomy
Spermatocele After Vasectomy

What is epididymis?

It is a narrow tightly coiled tube that connects testicles to vas deferens (a tube that carries sperm from testicles during ejaculation).

Sperm produced by the testes lack motility and fertility, their maturation takes place when they enter epididymis. After maturation, they move to the vas deferens and are released during ejaculation through the penis.

If a person does not ejaculate the sperm then the body reabsorbs the sperm by breaking down semen or releasing it through nocturnal emission (nightfall or sleep orgasm).

What is spermatocelectomy?

Spermaocelectomy refers to the removal of a sperm-filled cyst formed above the testicles known as spermatoceles.

The surgeon injects anesthesia in the groin region and makes a small cut to pull out the affected testicle and epididymis and removes the cyst and stitches the area back.

Who should I see if I have a spermatocele?

You should visit a urologist if you have to think you have a spermatocele. The urologist will diagnose the lump by the following methods;

Pointing light toward the lump, this way gives a rough idea of whether the lump is a solid mass or fluid filled. if it is filled with fluid then it is a spermatocele. You can also use this technique at home to keep a tab on testicular health.

Ultrasound: sound waves are used to identify whether the lump is a spermatocele or cancer.

When is surgery required?

Small cysts or lumps that are not causing any symptoms or pain do not need any treatment. However, if the cysts become big in size and start causing pain and discomfort then treatment is required.

There are several ways to treat spermatocele:

  • Medications such as painkillers or oral analgesics are recommended to help with the pain and discomfort. Antibiotics are also given to patients who are already suffering from urinary infections or to avoid the risk of infection.
  • Aspiration and sclerotherapy: In aspiration, the fluid is sucked out of the cyst, and in sclerotherapy, medicine is injected into the cyst to treat it. Both techniques carry the risk of damaging the epididymis and testicles which can result in infertility, infection, recurrence of cyst,
  • Surgical treatment or spermatocelectomy involves removing the cyst through an incision. Surgical removal also involves the risk of infertility, infection, hematoma, scrotal inflammation, etc.

What is Vasectomy?

Vasectomy is a surgical procedure where the surgeon ties the vas deferens (tubes that carry sperm from testicles to the urethra) to prevent fertility in males. It does not affect the production of testosterone or other male hormones.

The procedure takes only about 30 minutes and the patient is allowed to go home the same day after the procedure.

Although vasectomy is very easy to perform, its reversal is costly and does not guarantee full recovery of sperm production or male fertility. Due to this reason, it is not recommended for single childless males.

Risk Involved with vasectomy

Infection

Bruising

Bleeding: Sometimes there can be bleeding in the scrotum due to damage caused to surrounding blood vessels.

Post-vasectomy pain syndrome: This is a chronic condition (a disease that goes on for a long time) that can occur immediately or after several years after the vasectomy.

Spermatocele: Although rare, there have been cases of spermatocele after vasectomy surgery.

Why spermatocele occurs after vasectomy?

In a rare case, a man suffered from spermatocele 17 years after the spermatocele surgery. It was discovered that vasectomy surgery can cause increased pressure on the epididymis.

This enhanced pressure on the epididymis does not cause a spermatocele immediately but it can give rise to a spermatocele over the years with regular involvement in sexual activity.

Another medical review on post-vasectomy pain concluded the obstruction and dilation of the epididymis which is the coiled tube where sperm matures. This results in hydrocele or spermatocele which is later treated through surgical procedures.

Why do I have a hard lump in my epididymis?

Hard lump formation over the testicles does not necessarily mean that it is a cancer lump. There are different conditions related to testicles that can cause very similar symptoms such as:

Testicular torsion: spermatic cords get tangled due to rotation of testicles which produces a great deal of pain and discomfort. It needs immediate treatment.

Epididymal congestion: This can happen after vasectomy which involves sealing the tubes that carry sperm to semen. Since the testicles are still producing 1-15 million sperm per day so it can cause congestion in the epididymis which can lead to pain and discomfort.

Hydrocele: The build of fluid around the testicle is known as a hydrocele. It is very common in newborns which disappears itself and normally does not need treatment It is not common in adults and indicates inflammation or injury to the scrotum.

Varicocele: It is the pooling of blood in the veins inside the scrotum. The veins are responsible for carrying oxygen-deficient blood back to the heart but when they are not functioning properly, they cannot push the blood back to the heart and it starts pooling in the scrotum inside the veins. 1

The enlarged veins feel like a bag of worms on touching.

Spermatocele: It is a cyst above the testicles in the epididymis filled with fluid. It is not hard as it does not contain hard mass.

Orchitis: It is the inflammation of testicles due to a sexually transmitted disease or mumps virus.

Testicular seminoma: It is the most common testicular cancer among young people between the age group of 15-45. It starts with a small solid mass and it is very sensitive to radiation therapy and can be treated almost about 95% times.

Tunica vaginalis tumor: It is a tumor of the coating of the testes, this membrane is known as tunica vaginalis. This tumor is very aggressive and has a high recurrence and mortality rate.

Scrotal trauma: Bruise or direct hit can cause scrotal trauma. It can cause swelling of the scrotum (a pouch that holds testicles) and a lump in the epididymis.

In conclusion, you have to visit a doctor and get yourself tested to check which of the above-mentioned condition is causing the lump on the testicles.

About the author

Deepanshu has a Master's in chemistry. He has worked extensively on research subjects regarding cancer and radio nuclear science and has continually reviewed nutrition science.

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