Epididymal Cysts and Varicocele: Your Concerns Addressed

Q: Epididymal Cysts and Varicocele: Your Concerns Addressed

Hello： Blisters are relatively easy to understand, but they may not necessarily contain water; they could be filled with other fluids. <br>There are varying opinions on this, but the tactile sensation is generally the same. <br>How long does a normal epididymal cyst typically tak

Epididymal cysts and varicocele issues?

I have felt a hard, round lump about 0.3 cm in size around my left epididymis.
It feels smooth and moves when touched.
I previously went to the hospital for an examination, and the doctor said it was an epididymal cyst and that it wouldn't cause any issues, explaining that there are multiple ducts in the epididymis.
Could you please tell me if this is an epididymal cyst? Is an epididymal cyst the same as an epididymal fluid collection? Later, because I often experience soreness in my testicles, I visited another hospital, where they said I have mild varicocele (the doctor suggested that I massage my testicles if they are sore).
Is my varicocele caused by the epididymal cyst? How long does an epididymal cyst typically take to resolve, and how long is considered abnormal if it persists? (It has been over a month, and it is still there.) Can varicocele worsen from mild to severe due to running or playing sports? Is it possible that varicocele could be related to kidney issues, and should I get my kidneys checked? I am currently underweight; will gaining weight help improve my varicocele? I have visited multiple hospitals, and the 0.3 cm round lump around my epididymis is still present, and sometimes my testicles still feel sore, with some soreness even in the thigh area next to the testicles.
I am really worried about how this might affect my future fertility.

A Jie, 20~29 year old female. Ask Date: 2019/12/15

Dr. Du Shixi reply Urology

Hello: Blisters are relatively easy to understand, but they may not necessarily contain water; they could be filled with other fluids.
There are varying opinions on this, but the tactile sensation is generally the same.
How long does a normal epididymal cyst typically take to disappear, and after how long does it become abnormal? (It has been over a month and it is still present.) --> It may not necessarily disappear; some do, and some do not.
It is advisable to pay attention to lifestyle factors, and if there are no symptoms, it may be fine to wait.
On the other hand, a varicocele is caused by dilated blood vessels.
It contains blood, which is different from the previous condition.
Prolonged standing or abdominal straining can make it more pronounced, but some individuals may feel discomfort while others may not.
Intense physical activity can increase the severity.
(It is not easy for these symptoms to completely resolve.
For cysts, it is important to avoid trauma to the scrotum and see if they can disappear.
For varicoceles, avoid excessive abdominal strain, prolonged sitting or standing, and ensure that undergarments are not too tight to prevent poor venous return, which could worsen the condition.) Wishing you good health.

Reply Date: 2019/12/15

More Info

Epididymal cysts and varicocele are two distinct conditions that can affect male reproductive health, and understanding their implications is crucial for addressing your concerns.

Epididymal Cysts
An epididymal cyst, often referred to as a spermatocele, is a fluid-filled sac that forms in the epididymis, which is the coiled tube located at the back of the testicle responsible for storing and maturing sperm. These cysts are generally benign and can vary in size. The smooth, movable nature of the cyst you described (about 0.3 cm) aligns with typical characteristics of an epididymal cyst.
Epididymal cysts are usually asymptomatic and do not require treatment unless they become painful or bothersome. They can persist for a long time, and while many may resolve on their own, it is not uncommon for them to remain for months or even years without causing any issues. If your cyst has been present for over a month without significant changes, it is still considered normal, especially if it is not causing discomfort.

Varicocele
Varicocele, on the other hand, is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins in the legs. It can lead to discomfort, a feeling of heaviness, or a dull ache in the scrotal area, particularly after physical activity or prolonged standing. Varicoceles are known to potentially affect fertility due to increased temperature in the testicular area and impaired sperm production.

Your concern about whether the varicocele could be related to the epididymal cyst is understandable, but these two conditions are generally independent of each other. Varicoceles are not caused by epididymal cysts, and while they can coexist, one does not typically lead to the other.

Impact of Physical Activity
Regarding your question about whether activities like running or playing sports can exacerbate a varicocele, the answer is yes; physical exertion can sometimes increase discomfort associated with varicocele. However, it is unlikely to change the severity of the varicocele itself.

Kidney Health and Varicocele
You also mentioned the possibility of kidney issues contributing to your varicocele. While varicoceles are primarily related to venous drainage issues in the scrotum, certain kidney conditions can lead to increased pressure in the abdominal cavity, which may indirectly affect the veins in the scrotum. If there are concerns about kidney health, it would be prudent to discuss this with your healthcare provider and possibly undergo imaging studies to evaluate kidney function.

Weight and Varicocele
As for your weight, being underweight can sometimes affect overall health, including hormonal balance and potentially fertility. However, gaining weight alone is unlikely to resolve a varicocele. If you are concerned about your weight and its implications for your health, consider consulting a nutritionist or a healthcare provider for personalized advice.

Fertility Concerns
Your worries about future fertility are valid, especially with the presence of both an epididymal cyst and varicocele. While many men with varicocele can still father children, it is essential to monitor the situation. If you experience persistent pain, discomfort, or changes in your symptoms, or if you have concerns about fertility, it may be beneficial to consult a urologist who specializes in male reproductive health. They can provide a thorough evaluation and discuss potential treatment options if necessary.

In summary, while both conditions can coexist, they are generally independent. Monitoring your symptoms and maintaining open communication with your healthcare provider will be key in managing your health and addressing any concerns about fertility.

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