Is epididymal cyst lesion linked to impaired semen parameters in men?

No association exists between semen parameters and epididymal cyst lesions (ECLs), which include both spermatoceles and epididymal cysts, among men presenting for fertility evaluation, a study has shown.

A total of 861 men who had at least one semen analysis and scrotal ultrasound (SUS) available for review between 2002 and 2022 were included in this study. SUS data were as follows: testicular measurements, presence or absence of subclinical varicocele, and size and laterality of ECL.

The authors compared the demographic and clinical information, including serum testosterone and follicle-stimulating hormone and semen parameters, between men with and without ECLs.

Of the participants, 164 (19 percent) had unilateral right ECL (median 4 mm), 189 (22 percent) had unilateral left ECL (median 4 mm), and 113 (13 percent) had bilateral ECL.

Men with ECLs tended to be older than those without ECLs at the time of evaluation. However, there was no statistically significant difference in semen volume, sperm concentration, sperm motility, sperm morphology, total motile sperm count, or serum hormonal values between the two groups.

In the analysis of men with unilateral and bilateral ECLs, the size and laterality of ECLs showed no significant association with any of the semen parameters assessed.

“Patients should be counselled toward conservative management with observation for asymptomatic ECLs in the setting of fertility evaluation,” the authors said.