Since these cysts, as a rule, do not cause pain and are often not noticed, they rarely need treatment. The basic care for spermatoceles without pain is observation. But some men do have symptoms such as bothersome size or pain. When treatment is needed, there are several choices.
Oral pain or anti-swelling drugs may be used to ease pain caused by spermatoceles. No other type of medical therapy is needed. There is no drug to cure or prevent spermatoceles.
Minimally Invasive Therapies
Aspiration and sclerotherapy are 2 treatments that are available, but are not often used.
- Aspiration involves puncturing the spermatocele with a needle and drawing out its contents.
- Sclerotherapy involves injecting an irritating agent into the spermatocele sac. This causes it to heal or scar closed. This lowers the odds of fluid pooling again.
These options have been shown to work but in general, they are not recommended and rarely used. There is a risk of harm to the epididymis (tube that stores sperm), which can lead to fertility problems. Another common problem with both of these methods is that the spermatoceles can come back.
Spermatocelectomy is the standard treatment for spermatoceles that cause symptoms. The goal of surgery is to remove the spermatocele from the epididymal tissue and preserve the reproductive tract. This outpatient procedure is often done with local or general anesthesia. It usually takes less than 1 hour. Sometimes all or a part of the epididymis may need to be removed as well.