All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
Epididymal cysts are common and rarely require treatment. They are usually asymptomatic but may cause some anxiety to the patient. As they arise in the epididymis, the testis is palpable quite separately from the cyst and can therefore be readily distinguished from testicular tumours which arise from the testis.
Diagnosis can usually be made on the history and examination findings. Ultrasound scan is indicated in cases of diagnostic uncertainty and is important prior to referral to confirm the diagnosis and distinguish from differentials.
Patients should be advised to seek medical advice if the cyst becomes painful or suddenly starts increasing in size.
Key referral criteria:
AND
AND
Referrals without this information may be returned
Acute scrotal pain and tenderness may indicate testicular torsion or strangulated inguinal hernia and is a surgical emergency. Associated symptoms such as nausea, vomiting or abdominal pain may also be present.
Testicular cancer can present with testicular pain. Unilateral testis enlargement or change in shape or texture – refer on Suspected cancer fast-track pathway.
Arrange an urgent ultrasound scan of the scrotum, provided a scrotal swelling is not of acute onset, only if:
Reassure the patient that most epididymal cysts do not require treatment or imaging.
Consider referral if the patient has significant symptoms affecting quality of life and the cyst measures more than 10 millimetres (surgical treatment for smaller cysts may have a higher risk than benefit as symptoms are less likely to be cyst related).
Patients being referred should have an ultrasound scan prior to referral and the scan report should be attached to the referral.
AND
AND
Referrals without this information may be returned
e-Referral Service Selection
Specialty: Urology
Clinic Type: Not otherwise specified
Service: DRSS-South Devon & Torbay-Urology-Devon ICB- 15N
This guideline has been signed off on behalf of NHS Devon.
Publication date: February 2023