Epididymal cysts, also known as seminal cysts, occur in young adults. The cause of epididymal cysts may be the accumulation of semen due to obstruction of the vas deferens. The common site of epididymal cyst is the head of the epididymis, while the body and tail rarely occur. It originates from the epithelial cells of the testicular reticulum and is often several millimeters to several centimeters in diameter. The cystic fluid often contains spermatozoa. Most patients have no discomfort and are often found incidentally during a routine physical examination or may be discovered by the patient while bathing or self-examining the contents of the scrotum. Some patients may have a feeling of scrotal swelling, and the lesion develops slowly. Seminal cysts can also be multiple and present on both sides of the scrotum and may also involve one side of the epididymis. They are usually asymptomatic, but if the cysts are large, they may cause localized pain or discomfort. This may be the reason why some patients seek medical attention, but most patients come to the clinic because of a fear of the mass. Epididymal masses are most commonly caused by chronic epididymitis or granuloma. Epididymal tuberculosis is also a common cause of epididymal masses, but these masses are hard in texture and can be easily distinguished from cysts by tenderness. Cyst palpation: A round or ovoid mass can be palpated at the head of the epididymis with smooth surface, no pressure pain, cystic feeling, well-defined with surrounding tissues and no adhesions. Scrotal ultrasound can clearly show an echogenic fluid mass, which can be clearly diagnosed. Does it need treatment? 1. Seminal cysts do not cause any major damage to the body, so there is no need to be nervous. If the volume is not large and there is no symptom in general, no special treatment is needed, as long as it is observed regularly, and patients should be relieved of their worries. 2. If the cyst is complicated by infection, it can be treated symptomatically with oral antibiotics. 3.If the seminal cyst is too large and affects the patient’s daily life, surgery can be chosen to remove it. However, the surgery may destroy the epididymal duct and affect the transmission of sperm, so it should be cautious for patients who have not had children or have the requirement of having children again. 4.Seminal cyst surgical excision brings minor and rare complications, including scrotal hematoma, infertility (if the epididymis is removed), and testicular atrophy can occur if the blood supply to the testicles is affected.