Epididymal cyst is a harmless sac in the
testicles filled with fluid.[2] The most frequent clinical presentation occurs when a routine physical examination yields an unexpected finding, which is then confirmed by scrotal
ultrasonography.[1] Although the exact cause of epididymal cysts is unknown, it is likely a congenital anomaly associated with hormonal imbalances during the embryonic stage of development.[3]
Signs and symptoms
An epididymal cyst, a benign cystic fluid collection in the
scrotum, usually manifests as a painless swelling on top of the
testicle and can be inadvertently discovered during a physical examination.[2] The most typical clinical findings are scrotal mass and pain.[1]
Causes
The exact cause of an epididymal cyst is unknown, but it is most likely a
congenital anomaly associated with
hormonal imbalances during embryonic life.[3] Previous research has shown a correlation between the development of epididymal cysts and maternal exposure to endocrine disrupting substances like
diethylstilbestrol during male fetal development.[4][5] It has been determined that the causes of epididymal cysts in children are vasal or epididymal obstruction and environmental endocrine disruptors.[6][7] There has also been a suggestion that the
testicular dysgenesis syndrome may include an epididymal cyst.[8]
Diagnosis
An
ultrasound is used to confirm 20–30% of epididymal cysts that are found during a physical examination.[2]
Treatment
An epididymal cyst usually resolves on its own over time and doesn't need to be surgically removed.[2] Nonetheless, patients who experience excruciating scrotal pain or whose cyst size does not appear to be involute are advised to have their epididymal cysts surgically removed.[3]
^Gill, W.R.; Schumacher, G.F.B.; Bibbo, M. (1977). "Pathological Seman and Anatomical Abnormalities of the Genital Tract in Human Male Subjects Exposed to Diethylstilbestrol in Utero". Journal of Urology. 117 (4). Ovid Technologies (Wolters Kluwer Health): 477–480.
doi:
10.1016/s0022-5347(17)58502-x.
ISSN0022-5347.
PMID850321.
^Jarvis, LJ; Dubbins, PA (March 1, 1989). "Changes in the epididymis after vasectomy: sonographic findings". American Journal of Roentgenology. 152 (3). American Roentgen Ray Society: 531–534.
doi:
10.2214/ajr.152.3.531.
ISSN0361-803X.
PMID2644777.
^Skakkebæk, Niels E. (2002). "Endocrine Disrupters and Testicular Dysgenesis Syndrome". Hormone Research in Paediatrics. 57 (2). S. Karger AG: 43.
doi:
10.1159/000058100.
ISSN1663-2818.
PMID12065926.
^Skakkebæk, N.E.; Rajpert-De Meyts, E.; Main, K.M. (2001). "Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects: Opinion". Human Reproduction. 16 (5). Oxford University Press (OUP): 972–978.
doi:
10.1093/humrep/16.5.972.
ISSN1460-2350.
PMID11331648.
Further reading
Posey, Zachary Q.; Ahn, Hyeong Jun; Junewick, Joseph; Chen, John J.; Steinhardt, George F. (2010). "Rate and Associations of Epididymal Cysts on Pediatric Scrotal Ultrasound". Journal of Urology. 184 (4S). Ovid Technologies (Wolters Kluwer Health): 1739–1742.
doi:
10.1016/j.juro.2010.03.118.
ISSN0022-5347.
PMID20728143.