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Epididymal cyst
An epididymal cyst is a collection of fluid next to the epididymis. It is most often painless and is found by chance or at an examination.
What concerns does it address?
When is surgery needed, and when monitoring?
If the round lump is small at the examination and not bothersome, it can be monitored. If it is bothersome or starts to grow, removal is recommended.
→ Urology: examination and diagnostics
How is it done?
Through a short incision in the scrotum, the epididymis is reached, and the cyst is separated from the surrounding tissue and removed whole, with its sac — so that it does not come back. The removed tissue is sent for analysis. Supportive underwear is worn for a few days, and the stitches dissolve on their own.
When is the procedure not suitable?
The procedure is not done until an ultrasound confirms that the lump is a cyst and not a lump in the testicle itself, because a lump in the testicle needs a different work-up. It is postponed if there is active inflammation of the epididymis or testicle, until it has cleared up. In men who plan to become fathers we discuss the procedure with particular care, because an operation on the epididymis can damage the passage of sperm on that side.
General reasons for postponing a procedure (inflammation, a clotting disorder, smoking): When is a procedure postponed?
Anaesthesia
Before a procedure under general or regional anaesthesia, you are seen by the anaesthetist, who works full time at the clinic; the same doctor is also present during the procedure. The anaesthetic assessment and the anaesthesia for larger operations are included in the price of the procedure. What happens before, during and after anaesthesia is described on the Anaesthesia page.
Risks
Expected, and rare but serious → Risks and complications: what is the course of healing, and what is a complication?
Specialist and team
Specialty: urology — examinations, diagnostics and procedures.
When the procedure is done under sedation or general anaesthesia, the anaesthesia is led by a specialist in anaesthesiology, resuscitation and intensive care who works full time at the clinic.
In the operating theatre, the surgeon is assisted by head nurse Martina Šereg, with the help of nurses Kristina Jurešić and Mateja Tomorad, and in recovery the care assistant Mirjana Kovačić is with you. Martina also looks after preparation, scheduling and contact after the procedure.
Who will operate is decided at the examination, based on the findings and the type of procedure. You know the name of the surgeon before the procedure and meet them at the examination.
What happens at the examination?
A urological examination has two parts: a conversation about your symptoms, past illnesses and medicines, and a clinical examination. Depending on the findings, an ultrasound is done straight away, in the same visit, if needed. You receive the findings at the examination.
What if the result is not as agreed?
The result of a procedure is assessed at a follow-up visit, once the swelling has gone down and the scar has matured, not in the first weeks. If it differs from what was agreed at the examination, the same surgeon carries out the correction.
→ Poliklinika Barbel's correction policy
Frequently asked questions
Does the cyst have to be removed? No, if it is not bothersome. An epididymal cyst is benign and is monitored by ultrasound. It is removed when it grows, hurts, interferes with sitting and sport, or when its existence worries you so much that monitoring is not acceptable.
Will there be a scar? The cut on the scrotum is on average two to three centimetres long and after healing is hidden in the skin folds, so it is barely visible.
Can the cyst come back? When removed with its sac, rarely. A new cyst may form in another part of the epididymis, which is not a recurrence of the same cyst.
Does it affect fertility? The procedure itself rarely affects fertility, but the epididymis is a delicate structure through which sperm pass and there is a small risk that it becomes blocked on the operated side. The other side takes over the function. If you plan to have children, tell us at the examination.
How much does the result depend on care after the procedure? The larger the procedure, the more it depends on it, but it always does. Healing takes weeks and months and happens almost entirely at home, so the instructions you receive when you go home, about the wound, physical activity and the scar, are part of the procedure, not a recommendation.
Medical review: doctors of Poliklinika Barbel · October 2026.