An epididymal cyst is a small collection of fluid arising from the epididymis, part of the sperm collection tubules, which arise from the top of the testicle and convey sperm down into the vas deferens. These cysts are non-cancerous, but can gradually grow over time and become quite tense and painful, causing difficulty with daily activities and work in some cases. The diagnosis is made by physical examination and an ultrasound scan, which is mandatory for all scrotal conditions.
Epdidiymal cysts can be removed through a day surgery operation with an incision in the scrotum. This aims to remove just the cyst without damaging the fine sperm collecting tubules from which they arise. However, there is a real risk of scarring to the sperm collecting tubes after surgery, causing functional infertility on the affected side. For this reason, urologists are generally reluctant to perform removal of cysts on young men who haven't completed their family, particularly as cysts may arise on the other testicle in the future.