Diagnostic Considerations

The differential diagnosis of spermatocele includes the following:

Hydrocele
Varicocele
Hernia
Simple epididymal cyst
Neoplasm

Workup

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Rubenstein RA, Dogra VS, Seftel AD, Resnick MI. Benign intrascrotal lesions. J Urol. 2004 May. 171(5):1765-72. [QxMD MEDLINE Link].
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Jahnson S, Sandblom D, Holmäng S. A randomized trial comparing 2 doses of polidocanol sclerotherapy for hydrocele or spermatocele. J Urol. 2011 Oct. 186(4):1319-23. [QxMD MEDLINE Link].
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Shan CJ, Lucon AM, Pagani R, Srougi M. Sclerotherapy of hydroceles and spermatoceles with alcohol: results and effects on the semen analysis. Int Braz J Urol. 2011 May-Jun. 37(3):307-12; discussion 312-33. [QxMD MEDLINE Link].
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Tammela TL, Hellstrom PA, Mattila SI. Ethanolamine oleate sclerotherapy for hydroceles and spermatoceles: a survey of 158 patients with ultrasound followup. J Urol. 1992 Jun. 147(6):1551-3. [QxMD MEDLINE Link].
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Shah VS, Nepple KG, Lee DK. Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit. J Urol. 2014 Oct. 192 (4):1179-82. [QxMD MEDLINE Link].
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Sista AK, Filly RA. Color Doppler sonography in evaluation of spermatoceles: the "falling snow" sign. J Ultrasound Med. 2008 Jan. 27(1):141-3. [QxMD MEDLINE Link].
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Media Gallery

A sagittal section of the testicle. Idiopathic obstruction of the epididymal ducts is one hypothesis that explains the formation of spermatoceles.
Diagram of a spermatocele.
Spermatocele as seen prior to incision.
Intraoperative view of spermatocele with adjacent testicle and spermatic cord.
Spermatocele after complete excision.
A scrotal ultrasound demonstrating a spermatocele visible to the left of a normal testis.
Microscopic view of spermatocele lined with cuboidal epithelium.

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Author

Vernon M Pais, Jr, MD Associate Professor, Department of Surgery, Section of Urology, Geisel School of Medicine at Dartmouth

Vernon M Pais, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Urological Association, Endourological Society, Sigma Xi, The Scientific Research Honor Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: consultant -- Boston Scientific.

Coauthor(s)

Shaun E Wason, MD Resident Physician, Department of Surgery, Division of Urology, Dartmouth-Hitchcock Medical Center

Shaun E Wason, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Edward David Kim, MD, FACS Professor of Urology, Department of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American Society for Reproductive Medicine, American Urological Association, Sexual Medicine Society of North America, Society for Male Reproduction and Urology, Society for the Study of Male Reproduction, Tennessee Medical Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Endo, Antares.

Additional Contributors

Allen Donald Seftel, MD Professor of Urology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; Head, Division of Urology, Director, Urology Residency Training Program, Cooper University Hospital

Allen Donald Seftel, MD is a member of the following medical societies: American Urological Association

Disclosure: Received consulting fee from lilly for consulting; Received consulting fee from abbott for consulting; Received consulting fee from auxilium for consulting; Received consulting fee from actient for consulting; Received honoraria from journal of urology for board membership; Received consulting fee from endo for consulting.

Shlomo Raz, MD Professor, Department of Surgery, Division of Urology, University of California, Los Angeles, David Geffen School of Medicine

Shlomo Raz, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, California Medical Association

Disclosure: Nothing to disclose.

Fluid Aspirated from Spermatocele (Volume in mL)	Sclerosant Solution Injected (Volume in mL)
< 20	2
20-50	3
51-100	5
101-200	10
201-300	15
301-400	20
401-800	25
>800	30

Spermatocele Differential Diagnoses

Diagnostic Considerations

References

Tables

Contributor Information and Disclosures

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