Spermatoceles - Causes, symptoms and treatment. MF.

A spermatocel or a seed cyst is a tumor of testicular tissue bounded by a fibrous membrane, and inside it contains spermatozoa, spermatocytes and seminal fluid.

Causes of the disease

In its origin, the spermatoceles are divided into congenital and acquired. Concerning the innate variant, it occurs as a result of a violation of embryogenesis, when the vaginal process of the peritoneum does not completely overgrow. As a rule, the congenital spermatoceles is a cyst, measuring up to 2.5 cm in diameter, which contains a clear liquid without admixture of spermatozoa and spermatocytes. In addition, congenital spermatoceles do not block the passage of the vas deferens, which means it is not complicated by infertility.

Much more common is acquired spermatoceles. This disease is a consequence of a previous trauma or acute inflammation in the testicle. Most often it develops against the background of vesiculitis, epididymitis or orchitis. The pathogenesis of the acquired spermatoceles is that trauma or the transferred inflammatory process disrupt the permeability of the vas deferens, which makes sperm outflow from the testicle difficult. Because of this, the ejaculate accumulates in some part of the vas deferens, forming a cyst that constantly increases. Such a cyst can be multi-chambered, and its contents have a turbid consistency with a large number of spermatozoa and spermatocytes.

Symptoms of spermatoceles

In most of its cases, the cyst is completely asymptomatic. Men notice it only when a small, painless compaction in the form of a ball begins to be felt in the upper part of the scrotum. The reproductive and sexual functions may also remain normal.

When the cyst grows to an especially large size, it begins to press on surrounding anatomical structures, resulting in the development of specific symptoms. Such patients complain of an increase in the size of the scrotum, discomfort and pain during exercise, sexual intercourse and even walking. If the inflammatory process is attached to the cyst, reddening and swelling of the scrotum can occur. At the same time, education becomes very sensitive and painful. And the pain intensifies when touched. Among the common symptoms, general weakness, malaise and a slight increase in body temperature can be observed.

Appearance of the spermatocele

Characteristic is the clinical picture and with rupture of the cyst. When its contents are poured into the cells of the scrotum, it leads to diffuse inflammation. When the egg is involved in the process with the appendages, the patients complain of bursting pain in the scrotum, swelling and fever. Quite often, because of the violation of the hematotestick barrier, a large number of antibodies are produced in the human blood that promote the spread of inflammation to another testicle. This condition is dangerous because in bilateral orchitis, male sterility often develops.

Diagnosis of the disease

Among all the diagnostic procedures that are performed with a spermatocel, it is necessary to isolate ultrasound and diaphanoscopy. As for the latter, it has become widely popular due to its high efficiency and low cost. The method of diaphanoscopy consists in the fact that the pathological neoplasm is revealed through the transmission of the scrotum by a special device. At the same time, the so-called shadow appears in the spermatocel area, which makes it possible to suspect the presence of a pathological neoplasm.

Despite the popularity of diaphanoscopy, it does not give a clear answer to what kind of education is in the scrotum. More accurate information can be obtained by evaluating the results of ultrasound. On ultrasound, the spermatoceles look like a homogeneous neoplasm, identical in density to the liquid. Also, using ultrasound, you can determine the exact location of the cyst, which is necessary to select an access point for surgery.

Scheme of spermatoceles

Treatment of spermatoceles

The basis for the treatment of this disease is the surgical procedure , which can be performed both under local and under general anesthesia. However, recently the local operation with this disease is very rare. The method of choice is general anesthesia, which gives fewer local complications and not so much traumatizes the human psyche. And if you take into account the fact that most of these operations are performed in childhood, this becomes especially urgent.

The procedure of surgery consists in the radical removal of the cyst. With congenital pathology, surgical intervention ends there.

If you are treating the acquired spermatoceles, you must remember that it is located at the site of the vas deferens. And this means that at the end of the operation the patency of this anatomical duct should be restored. Modern surgical technologies use for this purpose different types of prostheses and transplants.

If the patient refuses to perform an operative intervention, or if there are any contraindications to the latter, puncture cysts is possible. It is a puncture of the cyst cavity with a thin needle and then pumping out its contents. As a rule, after performing such manipulation, a relapse of the disease is observed, so recently they refuse it. In addition, puncture can be one of the causes of complications of spermatoceles.

With a small cyst size, as a rule, expectant management is used, which is the observation of the dynamics of the growth of education for several months. With a stable size of the spermatoceles and the absence of any clinical manifestations, surgical intervention can be avoided.

Features of diet and lifestyle with spermatocele

The presence of spermatoceles threatens the patient with complications, therefore, in case of refusal of surgical intervention, it is necessary to lead a careful lifestyle with respect to the scrotum. Overcooling the groin area can lead to inflammation or even suppuration of the spermatoceles, so it is necessary to avoid wet weather and wear warm comfortable underwear.

Even a minor scrotal injury with a spermatocel can cause a rupture of the cyst. Thus, it is necessary to minimize its possibility. First of all, it concerns representatives of contact kinds of sports, such as football, basketball, hockey.

Rehabilitation after illness

Patients who underwent surgery on the scrotum are advised to apply ice to the wound in the first days after the operation. The fact is that the scrotum is very pronounced subcutaneous tissue and the skin is stretched enough, and this can lead to an easy occurrence of swelling and bruising in this area. In addition, it is mandatory to use special elastic underwear that will support the scrotum in a more physiological position and promote proper healing of the wound.

Treatment of spermatoceles with folk remedies

Folk methods of treatment can be not only ineffective, but even dangerous. The fact is that some traditional healers are trying to eliminate the cyst, stretching it. As you know, this can lead to rupture of the last and diffuse inflammation of the scrotum.

Other folk methods in the form of lotions and ointments, in principle, do not harm the cyst, but also do not bring any positive effect. Thus, their use will only spend your money and time, for which the cyst, of course, several times increase in volume.

Complications of the spermatic cyst

The most common complication of the spermatocele is inflammation of the cyst with its suppuration .This can occur due to hypothermia of the body or penetration of any pathological bacterial or viral agent into the scrotum. Inflammation of the cyst is manifested by a sharp increase in one of the half of the scrotum, reddening of the skin above it and no less severe soreness.

The second most frequent and dangerous complication is the rupture of the spermatic cyst .As a rule, this happens due to mechanical trauma of the cyst. If a break occurs in aseptic conditions and a small amount of content is poured out, it can dissipate without a trace. This is the most favorable outcome of the disease. And if the content of the cyst is large or it has a large number of spermatozoa in its composition, then diffuse inflammation of the scrotum develops on this background, which, first of all, extends to the testicle and its appendages.

Another complication that occurs most often with the acquired form of spermatoceles is the male infertility form .As the cyst grows on the path of the passage of the vas deferens, this interferes with normal sperm outflow. And often the ejaculate of one testicle is not enough to normally fertilize an egg.

Also a large spermatocele can squeeze the nerves or vessels of that pass in this area. In the first case, this will be manifested by sharp soreness and a sensitivity disorder, and in the second edema of the scrotum, the pubic area and the anterior surface of the thigh.

Prevention of spermatoceles

Prevention of congenital spermatoceles is to eliminate the negative effects on the fetus during pregnancy. This can be achieved by excluding alcohol, smoking and malnutrition. In addition, the cause of congenital spermatoceles can be intrauterine trauma or frequent stressful situations in pregnant women.

Since the cause of the acquired spermatoceles most often can be a mechanical trauma or inflammatory process, they must first of all beware. As for scrotal injury, this is most relevant for athletes who engage in contact sports. In their situation, it is necessary to wear special protective bandages.

As for the inflammatory process, it usually occurs against a background of any bacterial infection or hypothermia, both local and general. If orchitis or epididymitis could not be avoided, then after the transfer of the disease must be periodically examined from a urologist who will be able to identify spermatoceles at the initial stage, when it is much easier to be surgically intervened.

Rev.doctor urologist Astashin Е.Е.