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A spermatocele is derived from a part of the sperm-conducting mechanism of the epididymis at the upper pole of the testis. Usually a painless and non-cancerous condition that can occur at any age, a spermatocele is generally filled with a milky liquid that resembles barley water or a clear fluid that may contain dead spermatozoa. Some spermatoceles may be large enough to make the patient think that he has three testicles, but most of them are small in size.

Spermatoceles may not give rise to any signs or symptoms and mostly remain the same size for years together or sometimes even for life. If a spermatocele grows in size, it may produce discomfort or pain along with a feeling of heaviness in the scrotum or a drawing sensation along the spermatic cords.

Why some men develop spermatoceles is yet not known. However, many experts believe that the condition occurs due to a blockage in one of the tubes that drains spermatozoa from the testicle into the epididymis. It can also be caused by trauma or inflammation. If any portion of the epididymis is obstructed because of scar formation, a spermatocele may form.

In most cases, a spermatocele that is small and not causing any problem is left alone. No treatment is required until and unless it begins to grow or the patient starts experiencing some discomfort because of it. For occasional pain, over-the-counter painkillers may be prescribed. If the pain becomes a regular feature or the cyst enlarges, surgical intervention becomes necessary. The surgery, known as spermatocelectomy, involves incision and separation of the spermatocele from the epididymis.

Wearing a gauze-filled, athletic supporter is recommended for a few days after surgery to apply pressure and protect the site of the incision. Applying ice-packs is also advisable to reduce the swelling. Oral painkillers and anti-inflammatory medicines may be prescribed by the doctor to reduce discomfort. Antibiotics are usually given to prevent any post-surgical infections and to facilitate healing of the surgical wound.

Sclerotherapy is another treatment option for a patient with a spermatocele. In this method of treatment, the spermatocele is punctured using a needle, the fluid contained in it is withdrawn, and an irritant solution is injected into the emptied cyst. This triggers an inflammatory response that obliterates the space that had earlier been occupied by the withdrawn fluid, thereby minimizing the chances of a recurrence. This is the treatment of choice for patients who are well beyond the reproductive age group or in whom surgery may be contraindicated; for example, in men suffering from bleeding disorders.

There is no foolproof way of preventing a spermatocele. However, performing a testicular self examination at least once in a month may be helpful in detecting the problem. Such an examination is quite simple. All that one needs to do is to stand in front of a mirror and look for any scrotal swelling. This should be followed by examination of each of the testicles by gently rolling them in between the thumb and the other fingers. However, it must be borne in mind that the right testis is normally larger in size and lies higher in the scrotum as compared to the left testis.

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