A hydrocele, where fluid builds up in the sheath around a testicle (see figure 1). An epididymal cyst, where fluid collects in the epididymis (a tube-like structure that stores sperm).
What are the benefits of surgery?
If the lump is large, surgery will ease any discomfort you may have and make it easier for you to walk.
If you want to have children, it is best to leave an epididymal cyst alone. Surgery in the area of the epididymis can cause scarring which reduces your fertility.
Are there any alternatives to surgery?
The fluid can be removed using a needle but the fluid usually builds up again. It is possible to inject a drug that stops the fluid from coming back.
What does the operation involve?
Surgery to remove benign scrotal lumps is usually performed under a general anaesthetic. Sometimes a spinal anaesthetic is used. The operation usually takes between twenty and fifty minutes.
Your surgeon will make a small cut in your scrotum. For a hydrocele, your surgeon will remove the fluid from the sheath and either remove the sheath or stitch it together. Your surgeon will either remove an epididymal cyst whole or they will cut away the ‘roof’ of the cyst and drain the fluid out.
What complications can happen?
1. General complications of any operation
Pain
Bleeding
Difficulty passing urine
2. Specific complications of this operation
Infection in the wound
Reduced fertility if the surgery is to treat an epididymal cyst
How soon will I recover?
You should be able to go home the same day or the day after. Most men can return to normal activities within two to four weeks.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.
For a hydrocele, surgery usually cures the problem. However, fluid can build up again.
There is usually more than one epididymal cyst and surgery can only treat the larger ones. If the smaller ones get bigger, the problem will come back.
Summary
Lumps in the scrotum are common. However, some cause problems and can be treated by surgery.
Paying for your operation
Surgery for benign scrotal lumps costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
