J Urol. 2024 Aug 26:101097JU0000000000004224. doi: 10.1097/JU.0000000000004224. Online ahead of print.
ABSTRACT
PURPOSE: Epididymal cyst lesions (ECL) include both spermatoceles and epididymal cysts, and are often incidentally found on physical exam or scrotal ultrasound (SUS). We aimed to determine the association of ECL and semen parameters among men presenting for fertility evaluation.
MATERIALS AND METHODS: We reviewed men at our institution who had at least one semen analysis (SA) and SUS available for review between 2002 to 2022. SUS data included testicular measurements, presence or absence of subclinical varicocele, and size and laterality of ECL, if present. Demographic and clinical information including serum testosterone and follicle-stimulating hormone (FSH) and semen parameters were compared between men with and without ECL.
RESULTS: Among 861 men, 164 (19%) had unilateral right ECL (median 4 mm, interquartile range [IQR] 3-8 mm), 189 (22%) had unilateral left ECL (4 mm, IQR 3-9 mm), and 113 (13%) had bilateral ECL. Patients with ECL were significantly older than men without ECL at the time of evaluation, but had no statistically significant difference in semen volume, sperm concentration, sperm motility, sperm morphology, total motile sperm count, or serum hormonal values. Analysis of men with unilateral and bilateral ECL showed that ECL size and laterality did not significantly correlate with any semen parameter evaluated.
CONCLUSION: We found no association between ECL and semen parameters. Patients should be counseled toward conservative management with observation for asymptomatic ECL in the setting of fertility evaluation.
PMID:39186830 | DOI:10.1097/JU.0000000000004224
