Testicular & Scrotal Conditions & Male Infertility
Epididymal Cyst
A harmless, fluid-filled lump in the tube behind your testicle. Usually painless and very common, these cysts are not cancerous and often don't need treatment unless they cause discomfort.
Key Takeaways
- A harmless, fluid-filled lump in the tube behind your testicle. Usually painless and very common, these cysts are not cancerous and often don't need treatment unless they cause discomfort.
- We offer specialist diagnostics and treatments. Book a consultation to discuss your options.
Clinical Overview
Understanding Epididymal Cyst
An epididymal cyst is a smooth, fluid-filled swelling found in the epididymis—the coiled tube that sits above and behind the testicle, responsible for storing and transporting sperm. These cysts are incredibly common; it is estimated that nearly 1 in 3 men in the UK will develop one at some point in their lives, particularly as they get older.
While most of these cysts are filled with a clear fluid, some contain sperm cells and are known as "spermatocoeles." Regardless of what is inside them, they are almost never cancerous and do not increase your risk of developing testicular cancer.
The standard clinical advice is to leave these cysts alone unless they cause physical discomfort or grow large enough to get in the way of daily activities. Because they are located outside the testicle itself (extratesticular), a GP can usually tell them apart from more serious conditions during a physical exam or a quick ultrasound scan.
What to Look For
Symptoms, Causes & Risk Factors
01
Common Symptoms
A small, firm lump: Often feels like a pea at the top or back of the testicle.
Easy to move: The lump usually feels separate from the testicle itself and can often be "flicked" or moved between your fingers.
Painless: Most men don't feel any pain, although larger cysts can cause a dull, heavy ache.
A "heavy" scrotum: A dragging sensation, especially after standing for long periods.
Smooth shape: The swelling is typically smooth and round, rather than irregular or "knobbly."
02
When to Seek Help
Any new lump: Even if you’re sure it’s a cyst, you should always see your GP to confirm it isn't anything serious.
Sudden pain: If a known cyst suddenly becomes tender, sore, or painful.
Rapid growth: If the cyst is getting noticeably bigger over a short space of time.
Skin changes: If the skin over the lump becomes red, hot, or inflamed.
Difficulty checking yourself: If the cyst is so large it makes it hard for you to feel your testicle during a monthly self-exam.
03
Potential Causes
Blocked ducts: The tiny tubes in the epididymis can sometimes become blocked, causing fluid to back up.
Inflammation: Past infections (such as epididymitis) can leave behind small sacs of fluid.
Minor injury: A "knock" or trauma to the groin area.
Dilated tubes: The sperm-carrying tubes may naturally widen and form a pocket over time.
Unknown (Idiopathic): In many cases, they simply form for no obvious clinical reason.
04
Risk Factors
Age: You are much more likely to develop an epididymal cyst if you are over 40.
Previous infections: A history of STIs or urinary tract infections (UTIs) can cause the scarring that leads to cysts.
Groin trauma: Previous injuries to the testicles or scrotum.
Vasal surgery: Men who have had a vasectomy are slightly more likely to develop spermatocoeles later in life.
Importance of Diagnosis
Why Early Diagnosis Matters
The main reason to get a diagnosis is for peace of mind. Many men feel a lump and immediately worry about cancer. A simple physical examination by a GP, often confirmed by a scrotal ultrasound, can provide immediate reassurance. The scan clearly shows that the lump is filled with fluid and is located safely outside the testicle.
Getting an accurate diagnosis also helps protect your future health. Because the epididymis is vital for transporting sperm, surgery to remove a cyst carries a small risk of causing a blockage or scarring, which could affect your fertility. By confirming the cyst is harmless, you can opt for "watchful waiting," which is often the safest choice for men who still wish to father children.
Importance of Diagnosis
Diagnostic Options & Investigations
To accurately identify the cause of your symptoms, our specialists use a range of targeted investigations. Explore the diagnostic tests below to understand how we confirm a diagnosis and plan your recovery.
Living With Condition
Living With Epididymal Cyst
- Observation & Reassurance
- Supportive Underwear
- Surgical Excision (Cystectomy)
- Aspiration
Most men with epididymal cysts don't need any treatment at all. You can live a perfectly normal life, and the cysts often stay the same size for many years. If your cyst is small and doesn't hurt, it is simply a harmless "anatomical quirk" that you can safely ignore.
It is still important to keep doing your monthly testicular self-exams. While the cyst itself won't turn into cancer, it can sometimes make it a bit trickier to feel the rest of the testicle. The key is to learn the "baseline" feel of your cyst so you can quickly spot if any new or different lumps appear nearby.
Short-Term Complications
03- Minor "twinges": Occasional sharp or dull discomfort in the scrotum.
- Anxiety: Worrying about the lump until it has been professionally checked.
- Clothing issues: Larger cysts can sometimes feel uncomfortable in tight-fitting trousers or during exercise.
Long-Term Complications
04- Chronic ache: A persistent dragging sensation due to the weight of a larger cyst.
- Infection: In very rare cases, the fluid inside the cyst can become infected.
- Rupture: The cyst can burst if you suffer a direct injury to the area, which can be painful.
- Fertility risk: If you choose to have the cyst surgically removed, there is a small risk of damage to the tubes that carry sperm.
Treatment Options
Treatment Options & Care Pathways
Explore the specialist interventions available for Epididymal Cyst. We offer a range of evidence-based treatments designed to address your specific symptoms, focusing on long-term recovery and your personal health goals.
Specialists
Our specialists for Epididymal Cyst
Leading experts for this condition. View profiles to see clinical backgrounds and current availability.
Mr. James ArmitageConsultant Urologist
Mr. Nimish ShahConsultant Urological Surgeon
Professor Christof KastnerAssociate Professor & Consultant Urologist
Mr. Kasra Saeb-ParsyConsultant Urological Surgeon
Mr. Oliver WisemanConsultant Urologist
Mr. David ThurtleConsultant Urological Surgeon
Professor John KellyConsultant Urological Surgeon
Mr. Laurian DragosConsultant Urologist
Mr. Tev AhoConsultant UrologistOur Commitment
Care you can trust
Every step of your care is delivered to the same standard: senior consultants, a personalised plan, and the safety of an accredited private hospital behind you.
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Receive evidence-based care delivered by senior NHS consultants in a professional, specialist setting.
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Your consultant will design a bespoke plan tailored to your condition, health goals and lifestyle.
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Patient Guidance
Frequently Asked Questions
Common questions about specialist referrals and consultations.
3 questions
A cyst itself rarely affects fertility, as the other testicle and the unaffected parts of the epididymis continue to function normally. However, the *surgery* to remove a cyst carries a risk of scarring the delicate tubes of the epididymis, which could cause a blockage. For this reason, we generally advise against surgery for men who are still planning to have children.
Reviewed 2 Mar 2026
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A cyst is almost always found *above* or *behind* the testicle and feels like a smooth, distinct grape or pea that you can sometimes move slightly. Testicular cancer usually feels like a very hard, fixed lump that is part of the testicle itself. However, the only way to be 100% sure is to have a scrotal ultrasound, which can clearly distinguish between fluid and solid masses.
Reviewed 2 Mar 2026
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While it is possible for small cysts to be reabsorbed by the body, most tend to remain the same size or grow very slowly over time. They don't 'dissolve' with medication or exercise. Since they are harmless, the goal of treatment isn't necessarily to make them disappear, but to ensure they aren't causing you pain or distress.
Reviewed 2 Mar 2026
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