Adenoma cyst

The cyst of the epididymis (defined by the medical term spermatoceles) is a kind of seminal cystic neoplasm containing a liquid substance in the internal cavity.

This tumor is benign, but at the same time it is not less dangerous: to take this disease seriously.

[1], [2], [3], [4], [5], [6], [7]

Causes of the cyst of the epididymis

There are several reasons and options for the development of cysts of the epididymis:

• cyst epididymis can form before birth, as a result of some defects in the period of intrauterine growth of the embryo (for example, non-infection of the parameconephric duct). Cysts of this kind contain in their cavity a fluid devoid of sperm;
• the cyst formation of the epididymis in 40% of cases may be preceded by traumatic scrotal lesions, infectious and inflammatory processes in the genital area, which lead to the coalescence of one or two vas deferens. As a consequence, the output of the seminal fluid overlaps, and the accumulation of male sex cells in the lumen of the canal. The walls of the channel, respectively, are stretched, and a cyst is formed, containing in its cavity accumulated seminal fluid with neutral or alkaline activity.

In addition to spermatozoa, lipid cells, leukocytes and epithelial particles can be found in the contents of the cyst, from which the walls of the cystic cavity are lined.

Cyst of the epididymis in men

The cyst of the testicle in men is a benign neoplasm.

The appendage itself is a long narrow channel that serves to develop, accumulate and promote spermatozoa. It also produces the liquid necessary for the maturation and motor activity of the male sex cells. Under normal conditions of a healthy male organism, the output channels of spermatozoa should be systematically emptied, but with certain disorders the epididymis is filled with seminal fluid, and a cystic formation with a capsular connective tissue membrane appears in it.

A further increase in the cyst provokes an excessive pressure on the vas deferens of the epididymis, as a result of which the normal outflow of the seminal fluid is disturbed. This fact can cause a breakdown in the reproductive function in men.

The cyst of the epididymis usually originates in adolescence, progressing and developing over time. The peak of development occurs in the 30-40-year-old age, and by the age of 50 a complete clinical picture of the disease has already been observed, which can affect about 30% of the total male population.

[8], [9], [10], [11], [12], [13], [14]

Symptoms of the cyst of the epididymis

Clinical symptoms of the epididymis of the testicle usually appear in the late stages of the development of the pathological process, in other cases the disease does not manifest itself at all, but is detected at random in case of self-examination or preventive examinations.

The epididymis cyst is usually small in size, about 2-5 centimeters in diameter, and practically does not cause concern to the patient.

Palpable, you can define a spherical, mobile, smooth-elastic and practically painless tumor in any area of the epididymis or in the spermatic cord. Sometimes an illusion is created about the alleged "third testicle".

Sometimes the cyst may have a persistent tendency to increase, in some cases manifesting significant and persistent pulling pains, especially during physical exertion or sexual intercourse. Education can increase so much that it often causes discomfort during walking, sitting, motor activity, and a feeling of pressure and heaviness in the scrotum and in the perineum.

In severe cases, it is possible to develop suppuration, inflammatory and stagnant processes.

Cyst of the appendage of the left testicle

Normal physiological structure of the scrotum is two-chamber, each chamber contains an egg, its appendage and the initial segment of the spermatic cord. On the left side, the testicle is usually heavier, and it is slightly lower than on the right side, but this does not affect their functional abilities in any way.

The cyst of the epididymis can develop both from the left and from the right side, and sometimes from both sides.

The cyst of the appendage of the left testicle is a relatively common retention cyst. Most often it is formed from the subordinate head and has the property of close fitting to the epididymis or is located on the stem. This formation has great mobility and is located behind the testicle, slightly above it. When the cystic tumor becomes noticeable, it is often confused with ovaries dropsy (hydrocele).

The cyst of the appendage of the left testicle can manifest itself at absolutely any age, it is found out by chance. If properly diagnosed, the hazard for the body is not.

[15], [16], [17]

Cyst of the appendage of the right testicle

The right testicle is anatomically located above the left and often has a slightly smaller size, which is associated with a reduced blood flow to the right side.

The cyst of the appendage of the right testicle can manifest itself in men of reproductive age, and much later. The most common in physically active young people, as a result of increased workload and frequent traumatization of the perineal region.

The clinical picture of the epididymis cyst is not always directly proportional to its size. Sometimes tiny cystic formations 3-4 mm in diameter located in the head of the epididymis can contribute to the appearance of drawing painful sensations, and large tumors with a dislocation in the tail of the appendage or along the spermatic cord differ in a sluggish asymptomatic course.

Cysts can be located singly and multitudinously, palpable on the back of the testicle apart from it.

Progressive growth of the cyst appendage of the right ovary provokes an increase in the size of the right scrotum, which makes it possible to detect the existing pathology.

[18], [19], [20], [21], [22], [23]

Cyst of the head of the epididymis

The cyst of the head of the epididymis is a bulky spherical benign neoplasm located in the scrotum above the testicle and representing a dense fibrous capsule with internal contents from the seminal fluid. The head zone of the appendage is the most common localization of cystic neoplasm of the testicle. Sometimes even insignificant cysts formed in the area of the head of the appendage can provoke periodic pulling pains and a feeling of heaviness and pressure in the scrotum or in the perineum. Such a cyst must necessarily be shown to a specialist for conducting a differential diagnosis with other possible tumors in the testicle.

With a calm, uncomplicated course, this cystic formation, as a rule, does not pose a special threat to the functional abilities of a man; it has a smooth surface, a spherical shape, a dense elastic consistency and is visible through transmitted light, which is an essential difference in the cyst of the head of the appendage from other tumors.

[24], [25], [26]

Diagnosis of the cyst of the epididymis

Diagnosis of the cyst of the epididymis is carried out, first of all, on the basis of the clinical picture, the characteristic complaints of the patient and the results of a palpatory examination: the contours of the cystic densely-elastic formation are probed in the scrotum.

Additional diagnostic methods - diaphanoscopic and ultrasound of the scrotum - allow you to finally confirm the correctness of the diagnosis.

Diaphanoscopy is the use of a directional beam of transmitted light. The structure of the cyst of the epididymis is capable of perfectly transmitting light, so during the transmission, the dimensions of the tumor and the color of its contents are clearly visible.

Examination of the scrotum by ultrasound is the most common method of diagnosing cysts. It allows to detect and differentiate the cyst, to determine its size, contours, wall thickness.

Magnetic resonance or computed tomography is a method used no longer to diagnose the cyst of the epididymis, but to differentiate it with more serious tumor processes.

It is extremely rare to prescribe a puncture cyst to determine the nature of the contents in its cavity.

[27]

Treatment of cysts of the epididymis

Cysts of the appendage, characterized by an asymptomatic course and uncritical dimensions, do not require urgent therapeutic actions: wait-and-see tactics may be applicable to them.

The sclerotherapy method of cyst treatment is now practically not applied because of the increased risk of recurrence of the disease, and also because of the danger of impaired spermatogenesis: this method can be offered only to men who in the future no longer want to have children. The essence of this procedure is the extraction of the seed substance from the cystic cavity and the introduction of a specific sclerosing substance instead of it, which allows to glue the walls of the cyst and prevent further accumulation of fluid in it.

The method of electrocoagulation is quite new and quite popular. Relapses after such treatment are rare, and the period of convalescence is minimal.

Alternative means for getting rid of the cyst of the epididymis are often used, but the effectiveness and safety of their use has not been scientifically proven. Here are some examples of alternative recipes:

• a tablespoon of cocklebur cocktail ordinary brewed a glass of boiling water, take two tablespoons 4-5 times a day;
• a teaspoon of sage leaves are brewed in a glass of boiling water, take two tablespoons up to 4 times a day;
• a teaspoon of arnica mountain insist in a glass of boiling water, take a tablespoon of infusion up to 4 times a day.

However, to this day the most radical method of treatment remains surgical intervention.

Removal of cyst of epididymis

Operative treatment involves the use of local or general anesthesia and requires temporary hospitalization. The recovery period after surgery in the absence of complications is about 10 days.

The technique of the operation to remove the cyst of the epididymis is as follows: a small incision is made along the longitudinal seam of the scrotum through the scalpel, through which the testicle is withdrawn, then a thorough excision and extraction of the cyst is performed, trying in no case to damage it. After this, the testicle is gently refilled, followed by a careful wound suturing. Stitches must be applied with jewelry caution to prevent the occurrence of cicatricial changes in the tissues in the future, which will certainly affect the process of formation and movement of spermatozoa. Remote education is necessarily subjected to histological examination. Seams are usually removed after a week.

A month after the operation it is recommended to visit the urologist again for a repeated preventive examination.

Prophylaxis of the cyst of the epididymis

Preventive measures against congenital anomalies of the epididymis, provoking the appearance of a cyst, unfortunately, do not exist.

As a prophylaxis for the development of the acquired cyst, the influence of risk factors should be limited: avoid injuries to the perineal organs (even a microtrauma of the testicle may contribute to the formation of cystic formation), timely treatment of infectious and inflammatory diseases of the testicles, urethra, prostate gland, avoid prolonged low- and high-temperature effects on the genital organs. It is also recommended to protect against sexually transmitted infections: during a sexual relationship it is important to use a condom.

If an unknown dense formation in the scrotum is detected or a characteristic clinical picture of the disease is present, it is necessary to consult with a urologist and undergo an appropriate examination. Early tumor detection favors effective treatment, and also reduces the risk of complications.

Prognosis cysts epididymis

The prognosis and the expected outcome of the operation to remove the epididymis cyst are very favorable. Radical removal of education is considered the best therapeutic method for solving this pathological problem. About 95% of operated patients note an improvement in spermatogenesis and relieving of periodic pain in the scrotum.

The prognosis after the sclerotherapy procedure is much less optimistic: various complications can occur, such as a chemical inflammatory process leading to tightening of the scrotal tissues, reproductive failure, recurrence of the cyst, attachment of infection.

In principle, the risk of damage exists in any procedure, especially when it comes to surgical intervention. Therefore, it is important to choose a qualified urologist to prevent possible gross damage to the appendage.

However, the overall prognosis of the disease is quite favorable. Pains after treatment pass, the cosmetic problem is solved, the reproductive function of a man comes to normal.

Be attentive to yourself and your health, pay attention to the appearance of neoplasms in your body, even if it is such an asymptomatic tumor as the cyst appendage.