any preceding instances of injury. Scarring of any part of the epididymis due to trauma or inflammation can cause it to become obstructed and in turn form a spermatocele. Diagnosis Spermatoceles can be discovered as incidental scrotal masses found on physical examination by a physician or by self-inspection of the scrotum and testicles. The various types of diagnosis for spermatocele types include hydrocele, varicocele, hernia, simple epididymal cyst, and neoplasm. The primary care physician may diagnose and manage benign causes of scrotal masses such as hydrocele, varicocele and spermatocele. However, if a "must not miss" diagnoses related to testicular masses such as testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer is suspected, the family physician must refer to a urologist. Finding a painless, cystic mass at the head of the epididymis that is clearly separate from the testicle can indicate a spermatocele. Shining a light through the mass through a process known as transillumination can also help differentiate between a fluid-filled cyst and a tumor, which would not allow as much light to pass. If uncertainty exists, ultrasonography of the scrotum can confirm the presence of a spermatocele. The location and history of any scrotal masses are crucial in determining whether or not the mass is benign or malignant. Lab tests such as a complete blood count (CBC test) or urine test can also be conducted to check for any possible infection or signs of inflammation. Spermatoceles come in varying sizes and shapes. Some spermatoceles are very small and can only be detected through an ultrasound. More commonly seen are spermatoceles that are a pea-sized lump. They tend to form above or behind a testicle and have a shape and size that looks like a pea. Larger growths have been reported to look similar to a third testicle and can be very discomforting. For those who are affected with large spermatoceles, some have reported feeling pain, heaviness, and fullness in the affected testicle. When to see a doctor If a person is experiencing pain and/or swelling in the scrotum or if a person notices a physical difference such as a mass during a testicular self-exam then they must seek medical attention quickly to help rule out any other causes and begin treatment. Special Populations Spermatoceles in Children Epididymal cysts may arise in children due to numerous different reasons. They may even originate from a disturbance in endocrine factors