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Treatments and drugs
By Mayo Clinic staffMost spermatoceles require no treatment because 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 treatments
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 down swelling
- 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.
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 sac to scar, which takes up the space the fluid occupied and may lower the risk of the spermatocele coming back.
However, the incidence of recurrence is still high, as is the risk of damage to the epididymis. Sclerotherapy usually is used only for men who are beyond their reproductive years and who have conditions, such as blood-clotting problems, that increase the risks of spermatocelectomy.
- Cooper CS, et al. Urology. In:. Doherty GM. Current Diagnosis and Treatment: Surgery. 13th ed. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=5312459. Accessed Nov. 6, 2009.
- Spermatoceles. American Urological Association Foundation. http://www.urologyhealth.org/search/index.cfm?topic=530&search=spermatocele&searchtype=and. Accessed Nov. 6, 2009.
- Scrotal masses. In: Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/169561838-3/913428548/1565/762.html#4-u1.0-B978-1-4160-3675-3..50081-2--cesec29_4564. Accessed Nov. 6, 2009.
- Schneck FX, et al. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/169561838-3/913428548/1445/130.html#4-u1.0-B978-0-7216-0798-6..50129-1--cesec70_8117. Accessed Nov. 6, 2009.
- Sandlow JL, et al. Surgery of the scrotum and seminal vesicles. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/169561838-3/913428548/1445/37.html#4-u1.0-B978-0-7216-0798-6..50036-4--cesec20_2551. Accessed Nov. 6, 2009.
- Tiemestra JD, et al. Evaluation of scrotal masses. American Family Physician. 2008;78:1165.
