Epididymal cyst removal (excision of epididymal cyst (spermatocele))

What is epididymal cyst removal?

An epididymal cyst is a fluid-filled swelling of the epididymis, the coiled tube that sits on top of and behind the testicle and carries sperm away from it. These cysts are very common, usually harmless, and often cause no symptoms. When the fluid contains sperm, the cyst is sometimes called a spermatocele.

Most epididymal cysts do not need any treatment. They are removed only when they grow large, become uncomfortable or painful, or bother you enough to want them gone. Surgery involves a small cut in the scrotum to separate and remove the cyst from the epididymis and testicle.

The single most important point to understand is the trade-off around fertility. Removing a cyst can interrupt the passage of sperm on that side, and this may be permanent. For most men this does not matter, but if you have not completed your family, or fertility is important to you, this needs careful discussion before deciding on surgery.

Draining the cyst with a needle is not a lasting solution, because the fluid almost always comes back quickly. So if treatment is wanted, removal is the usual option, while simply leaving a harmless cyst alone is often the most sensible choice.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Removal vs needle drainage vs leaving it alone

Many harmless cysts are best left alone. Removal is for cysts causing real symptoms, weighed against the small fertility risk.

Preparing for your surgery

• Have the swelling examined to confirm it is a harmless epididymal cyst and not something needing different treatment; an ultrasound scan is sometimes done.
• Discuss fertility before deciding, especially if you have not completed your family, as removal may affect sperm passage on that side.
• Be clear about how much the cyst actually bothers you, as small usually not painful cysts are often best left alone.
• Tell the team about all medicines, particularly blood thinners, and any allergies.
• Stop smoking beforehand if you can, as it makes complications more likely.
• Arrange a lift home after a day-case operation and supportive underwear or a scrotal support for afterwards.
• Plan to avoid heavy lifting and strenuous exercise for at least four weeks.

What happens

The operation is usually done under a general anaesthetic (asleep) or a spinal anaesthetic (numb from the waist down). You may be given compression stockings and a blood-thinning injection to reduce the risk of clots, and antibiotics before the procedure.

The surgeon makes a small cut in the skin of the scrotum and carefully separates the cyst from the epididymis and testicle, then removes it. Because the epididymis carries sperm, removing the cyst can interrupt this passage on that side, which may be permanent. The skin is closed with dissolvable stitches that disappear over two to three weeks.

Most people have the operation as a day case and go home the same day with a scrotal support to wear.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The most important issue to weigh is fertility: removing the cyst can interrupt sperm passage on that side, and scarring of the epididymis can impair fertility, so think carefully if you may want children. The cyst can also recur, and a small number of men develop long-lasting scrotal pain after surgery, which is why a harmless, usually not painful cyst is often best left alone. Discuss your individual risks with your surgeon.

Published figures to discuss

The figures below are taken from UK urology patient information and are expressed as cautious frequency bands rather than precise percentages, because individual risk varies with the size and number of cysts, the surgery, and your health. Your surgeon and anaesthetist can estimate your own risk.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is usually straightforward. The scrotum is swollen and bruised at first and uncomfortable for a week or two, and supportive underwear makes this easier.

• Swelling and bruising of the scrotum for several days to a couple of weeks
• Discomfort for about one to two weeks, helped by simple painkillers
• The testicle feeling slightly bulkier than before
• Gradual return to comfort over the following weeks

Aftercare

• Wear a scrotal support or tight supportive underwear for the first few days for comfort.
• Take simple painkillers such as paracetamol or ibuprofen as needed.
• Keep the wound clean and dry for the first day; shower rather than bath until healed.
• Use ice packs wrapped in a cloth (not directly on the skin) to ease early swelling.
• Avoid heavy lifting and strenuous exercise for at least four weeks.
• Watch the wound for increasing redness, swelling or discharge, and contact the team if pain or swelling worsens day by day.
• Only drive again when you can do so safely, including an emergency stop.

• Scrotal support or tight supportive underwear ready
• Simple painkillers at home
• Lift home arranged for after a day-case anaesthetic
• Loose, comfortable clothing
• Time off work planned (often about 1–2 weeks)
• Heavy lifting and sport avoided for at least 4 weeks
• Clinic contact number saved for concerns

Scars and how they heal

There is a small scar in the skin of the scrotum, closed with dissolvable stitches that disappear over two to three weeks. Scrotal skin generally heals well and the scar usually becomes inconspicuous. Bruising of the scrotum is common at first and settles over a week or two.

⚠ Get urgent help if…

• Increasing, rather than easing, pain or swelling of the scrotum day by day
• Spreading redness, heat or discharge from the wound (signs of infection)
• A rapidly enlarging, tense, very painful scrotum (possible bleeding)
• Fever or feeling generally unwell
• Calf pain or swelling, or sudden breathlessness or chest pain (possible clot)
• Difficulty passing urine

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means the troublesome cyst is removed, the discomfort settles, and the scrotum returns to comfort over a few weeks, with the testicle perhaps feeling slightly bulkier than before.

It is realistic to know that the cyst can recur, that a new cyst can form, and that the operation carries a small risk of long-lasting pain or an effect on fertility on that side. Because these cysts are harmless, the decision to operate should be driven by genuine symptoms rather than the presence of the lump alone.

Removal usually gives a lasting result for the cyst that is taken out, but new cysts can develop and the treated one can occasionally recur. Any effect on sperm passage on the operated side may be permanent. There is no need for routine long-term follow-up if recovery is uneventful.

Combining with other procedures

Epididymal cysts are sometimes found alongside other scrotal swellings such as a hydrocele or varicocele. If more than one is present, your surgeon will discuss whether to treat them together or separately, weighing the benefit against the extra surgery and risk.

Follow-up & long-term care

A follow-up appointment is not routine for everyone, but you will be given advice on recovery and a contact for problems. Seek advice promptly if pain or swelling worsens, the wound looks infected, or you feel unwell.

• No routine long-term monitoring is usually needed after uncomplicated surgery.
• Report any new scrotal lump or change so it can be assessed.
• Seek prompt review if you develop ongoing scrotal or testicular pain.

Revision and secondary surgery reality

• The cyst can recur and new cysts can form, sometimes prompting repeat surgery.
• A haematoma or infection may occasionally need a further procedure to drain it.
• Any effect on sperm passage on the operated side may be permanent.
• Chronic pain after surgery can be difficult to treat, so the decision to operate should be carefully weighed.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written advice on wound care, supportive underwear and pain relief.
• A named contact and instructions to call if pain or swelling worsens day by day.
• Guidance on when to return to work, driving, lifting and exercise.
• Honest discussion of what to do if the cyst recurs or chronic pain develops.
• Advice on warning signs of infection, bleeding or a possible clot.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Surgeon's fee and whether one or several cysts are removed
• Anaesthetic fee (general or spinal)
• Hospital or theatre day-case facility fee
• Any pre-operative ultrasound scan
• Follow-up appointments if needed
• Policy on treatment of a recurrence or a complication

• Surgeon's fee and how many cysts are included
• Anaesthetist's fee
• Day-case facility fee
• Cost of any ultrasound scan or tests
• Follow-up appointment included or extra
• What happens, and what it costs, if the cyst recurs or a complication occurs
• Cancellation policy

On the NHS? Removal is available on the NHS when an epididymal cyst causes significant symptoms; small, usually not painful cysts are usually left alone, and private care is sometimes chosen for a shorter wait or particular surgeon.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Is this definitely a harmless epididymal cyst, and do I actually need it removed?
• How might this affect my fertility, and does that matter for me?
• What is my chance of the cyst coming back, or of long-lasting pain afterwards?
• Would it be reasonable just to leave it alone and review it?
• What anaesthetic will I have, and will it be a day case?
• What are your own results and complication rates for this operation?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for epididymal cyst removal

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BAUS — Removal of an epididymal cyst (patient leaflet) NHS — Testicle lumps and swellings Cambridge University Hospitals NHS FT — Removal of cyst from the epididymis

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.