Small cysts are best left alone, as are larger cysts that are an asymptomatic condition. Only when the cysts are causing discomfort and are enlarging in size, or the patient wants the spermatocele removed, should a spermatocelectomy be considered. Pain may persist even after removal.

Spermatocelectomy can be performed on an outpatient basis, with the use of local or general anesthesia.

A spermatocelectomy will not improve fertility.

Spermatoceles can originate as diverticulum from the tubules found in the head of the epididymis. Sperm formation gradually causes the diverticulum to increase in size, causing a spermatocele. They are due to continuity between the epididymis and tunica vaginalis.

They are also believed to result from epididymitis, physical trauma, or vasectomy. Scarring of any part of the epididymis can cause it to become obstructed and in turn form a spermatocele.

Ultrasound is useful if the cause is not certain based on the above measures. If the diagnosis of torsion is certain, imaging should not delay definitive management such as physical maneuvers and surgery.

Testicular pain, also known as scrotal pain, occurs when part or all of either one or both testicles hurt. Pain in the scrotum is also often included. Testicular pain may be either short or long duration.

Causes range from non serious muscular skeletal problems to emergency conditions such as Fournier's gangrene and testicular torsion. The diagnostic approach involves making sure no serious conditions are present. Testing may include ultrasound and blood tests.

Pain management is typically given with definitive management depending on the underlying cause.

An epididymal cyst is a cyst of the epididymis containing serous liquid. They are difficult to differentiate from a spermatocele except by aspiration, since a spermatocele contains milky-appearing sperm.