Epididymal cyst
Pathogenesis
- Arise in head of epididymis
- Multiple
- Occasionally occur as a complication of vasectomy
Approach
- Examine as for the scrotum
- Inspect
- Scrotum will appear normal unless cyst is unusually large
- Palpate
- Mass separate from testsis (within epididymis)
- Firm, may be loculated
- May be "brilliantly transilluminable" unless they contain sperm which case they do not transilluminate
- Distinct from superficial inguinal ring (can get above mass)
- Percuss
- Auscultate
Completion
- Examine contralateral hemiscrotum
Management options
- Non-surgical
- If not troublesome, should not be removed (esp younger men) - risk of operative damage and postoperative fibrosis causing subfertility
- Surgical
- Excision
