A Cured Case of Spermatocele

A 24 year old young man came to my chamber with a swelling in his pelvic region, since 2013. He lives in Oman, and a sales man in a departmental shop. He had a history of standing for long due to his job.

Sonographic Image- 27/04/15
Sonographic Image- 27/04/15
USG report- 27/04/15

He was complaining about pain in the lower abdomen-pelvis region. The pain felt always, but more after motion / walking / standing for long. Sensation as if pain radiating to the tip of the scrotum. After pelvic examination I saw a moderate size nodule/SOL in the left testicular region. It was soft on touch but hard enough to hold the shape. Swelling seems moves side to side, a little, on pressure, but it returns to its original position in no time. From this examination I have a diagnosis that it might be originated from epididymis. I asked the patient for a ultrasonogram of scrotum and FNAC (Fine Needle Aspiration Cytology) of the swelling. And found a fairly large epididymal cyst which is a spermatocele. I discovered that he is not having any Spermatorrhoea since this swelling. Though he had history of masturbation in his early puberty but for 1-2 years he is not performing it, but once or twice may happen in month!

I started with Arnica 1M, 4 hourly for 7 days. After 7 days, he felt that his pain has increased, but centered to the swelling, and radiation of pain seems disappeared. I re-examined the scrotum and surrounding and found that the swelling has become softer than before, but still remains the shape. I repeat Arnica, but in 10M potency, once in a day for next fifteen days and added Calc Fluor 30, twice for fifteen days. After 20 days he re-visited and found his pain has reduced to a considerable state. I re-examined his epididymis and found swelling has reduced in size, consistency seems same as before. Now I continued Calcarea Fluor 200, TD, and added Calc Phos 12X, 4 tabs TD, after meal. This time I advised to perform another USG after completion of the medicine. He returned with no pain and with this: Suggestive of mild epididymitis with a tiny epididymal cyst (lt), where cyst size is 4.4 mm X 2.8 mm.

USG report-23/06/15
Sonographic image- 23/06/15