Testicular Cyst In Men: Symptoms And Treatment, Consequences, Diagnosis

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2024-01-15 19:51

Testicular cyst in men

The content of the article:

1. Kinds

2. Symptoms of a testicular cyst in men

   1. Epididymal cyst
   2. Spermatic cord cyst
3. Diagnostics
4. Tactics for the treatment of testicular cysts

5. Surgical removal

   1. Preoperative preparation
   2. Operative intervention
   3. Postoperative period

6. Effects

   1. Operation-related
   2. Consequences of a prolonged lack of treatment for cystic neoplasms
7. Video

Testicular cysts in men are benign neoplasms of the genital organs and are rarely malignant. Most often occur in young and middle-aged people. The defeat is unilateral (only the right or left egg). With injuries, there may be a paired nature of the formations.

The manifestations of cystic testicular neoplasms depend on their anatomical location

Kinds

Testicular cystic formations are a collective concept that combines two pathologies:

View	Definition	Character
Spermatocele	Epididymal cyst in men	It is a cavity filled with serous fluid and covered with a connective tissue membrane. More often comes from the head of the epididymis and may have a leg. Depending on the origin, it can be congenital and acquired (a consequence of trauma, inflammation)
Funiculocele	Spermatic cord cyst	The disease is also represented by a cavity, which is delimited by a connective tissue or fibrous membrane. Degeneration into fibrous tissue occurs with frequent injury (the reason is sports injuries).

Treatment is carried out upon detection. The exception is children under 6 months of age, in this case, a wait-and-see approach is indicated for up to a year.

Symptoms of a testicular cyst in men

Manifestations will depend on the type of formation, which is associated with the peculiarity of the structure of the anatomical structures.

Epididymal cyst

The clinical manifestations of cystic neoplasms of the epididymis (epididymis) will depend on their location (epididymis head, body, or tail). In accordance with this, the same size of formations can give an extremely different clinical picture. Typical symptoms:

1. The patient discovers the formation by chance while performing hygiene measures (typical for tail localization).
2. Pain sensations radiating to the groin area. Pain of varying intensity occurs in the case of localization of the formation in the head of the epididymis.
3. Compression of the vas deferens, which leads to impaired sperm excretion and the development of male infertility. At the initial stages, there are problems with conception, but as such, the diagnosis of infertility is not made, since the function of the testicles is not impaired.
4. Deformation and enlargement of the scrotum. Since the neoplasm affects one testicle, there is a clear tissue asymmetry. There is no hyperemia. The edema is minor.
5. It is palpated as a tight-elastic formation, therefore, it is incorrect to make a diagnosis solely with the help of a physical examination (in the photo, any option, regardless of location, looks the same).

Spermatic cord cyst

The onset of symptoms depends on the size of the formation (up to 2 cm clinically not manifested).

1. Pain in the scrotum. May radiate to the groin and perineum. In this case, it is necessary to carry out differential diagnosis with strangulated inguinal-scrotal hernias.
2. With a significant size of the formations, it becomes difficult to urinate, since in this case they occupy a large area and squeeze the surrounding tissues. Poor diagnostic sign, suspected malignancy.
3. A cyst in the scrotum is palpable as a tightly elastic formation of a round shape. It is often painless. Not soldered to surrounding tissues. The surrounding tissues are not changed. Regional lymph nodes are not enlarged.
4. Deformity and asymmetry are similar to epididymal cysts.

It is necessary to differentiate with malignant tumors, which in the early stages manifest similarly to cysts.

Diagnostics

Diagnosis of the disease includes the following points:

• collection of anamnesis (has no peculiarities);
• physical examination (palpable mass in the scrotum);
• laboratory and instrumental research.

The diagnosis of a cyst is confirmed using the following methods:

1. Diaphanoscopy. The method is based on the passage of light rays through the scrotum (the test is carried out in a dark room). The area of the scrotum with cystic formation has a more pink glow, since it does not contain dense structures that darken.
2. Sonography, or ultrasound. Allows not only to identify the cystic cavity, but also to determine the size, content, boundaries, condition of the surrounding tissues. Benign formations have clear contours, homogeneous contents, do not affect the surrounding tissues. There is no blood flow at the site of formation.
3. MRI / CT is used only if there is a suspicion of a malignant formation (fuzzy contours, heterogeneous contents, metastases).

From laboratory methods, cytological and histological examination of a remote cystic formation is isolated.

Tactics for the treatment of testicular cysts

Treatment is carried out in a planned manner and depends on the size of the education.

There are several tactics for managing patients with cystic neoplasms:

1. With a small size (up to 2 cm) and the absence of clinical manifestations, a wait-and-see tactic is chosen with ultrasound control every 2-3 months.
2. For large sizes, the operation is performed in a planned manner. The amount of intervention depends on the characteristics of the education.

If torsion, rupture, or other complications are suspected, emergency hospitalization and removal of the cystic formation are indicated.

Surgical removal

Preoperative preparation

The preoperative examination includes (a referral for tests is issued by a urologist in a planned manner):

• general blood analysis;
• general urine analysis;
• determination of blood group and Rh factor;
• coagulogram;
• tests for HIV, syphilis and hepatitis C and B;
• dentist consultation;
• ECG.

In each clinic, the list of necessary tests for the operation may vary slightly.

Operative intervention

There are several options for surgical treatment.

Treatment option	Description
Through open access	It is performed under general anesthesia. A small incision is made in the area of the scrotal suture. The tissues are dissected in layers and the testicle with the appendage is brought to the surface. The cyst is excised and sent for biopsy. The testicle with the epididymis, if necessary, is sutured and immersed in the scrotum. The wound is sutured in layers and cosmetic stitches are applied to the skin. It is possible to treat large cysts in this way when laparoscopy is not possible. The functions of the organ are fully preserved.
Laparoscopy	A more modern method that is minimally invasive and is the gold standard for treating small neoplasms. Special devices (video cameras, trocars) are used, which are inserted into the abdominal cavity. Cystic lesions are removed from the side of the abdomen, and not from the side of the scrotum, as with open access. As a rule, there are no complications.
Sclerotherapy	It is a special treatment method. It is better to use it in the elderly, as there is a high risk of developing infertility due to damage to the genitals - testicle, epididymis, vas deferens. A needle is inserted into the area of the cyst, the scrotum is fixed with the brush of the second hand, and the contents are removed. Further, a special composition is introduced into the cavity of the cyst - sclerosant, which ensures the soldering of the walls of the cyst. When the drug enters the surrounding tissues, sclerosis of the seminal ducts or other anatomical structures may occur, which leads to a complete loss of organ function.

Postoperative period

In the postoperative period, the use of a bandage and non-steroidal anti-inflammatory drugs (pain relief) is indicated. Physical activity of any nature is limited for a month (you cannot go in for sports, sex).

Removal of a testicular cyst can be performed open or closed, as well as using sclerotherapy

Effects

The consequences and complications of cystic formations can be divided into those associated with surgical intervention and those associated with the formation itself

Operation-related

1. Injury to the appendages. Often occurs during sclerotherapy (therefore, it is optimal to carry out it under ultrasound control).
2. Pain in the scrotum. The pain becomes permanent when the nerve fibers are crossed during the operation.
3. Infertility. Associated with the intersection and subsequent dressing of the spermatic cord. In this case, a vasectomy occurs - surgical contraception or sterilization.
4. Swelling and infiltration - in the first days after surgery, these are normal tissue reactions. If edema persists for 5-7 days, repeated surgery is indicated, since there is compression of organs (in particular, the testicle), ischemia and a gradual decrease in function.
5. Relapses of cysts. This happens more often when using laparoscopy than when conducting an open operation, due to incomplete excision of the cyst capsule.

Consequences of a prolonged lack of treatment for cystic neoplasms

1. Accession of a secondary infection by hematogenous, lymphogenous or contact pathways and the development of a purulent process in the testicular tissues. In this case, the clinic will have a vivid picture (hyperemia, edema, infiltration, sharp pain, intoxication).
2. Rupture of the cyst with the release of the contents into the surrounding tissue. Unlike ovarian ruptures in women, in men the abdominal cavity is not involved in the process. But the fluid that has entered the scrotum can suppurate and provide an inflammatory process.
3. Decreased normal testicular function (erectile dysfunction). A reversible phenomenon occurs when cysts are 3 cm or more.
4. Infertility, which is caused by compression of the vas deferens by a cyst. Reversible with timely treatment, in contrast to infertility caused by incorrect surgical intervention.

Since the testicles belong to paired organs, clinical symptoms and complications may not occur immediately (the healthier testicle partially takes over the function of the affected one).

Video

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

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